Advanced Family Dental Inc

Primary specialty

DentistTaxonomy code 122300000X

License

6259409921 Issued in UT

Legal business name

ADVANCED FAMILY DENTAL INC

Practice address

415 N Main
Suite 203
Cedar City, UT 84720

Phone

(435) 867-0644

Fax

(435) 867-0645

NPI assigned

Aug 30, 2006

Last updated

Feb 3, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mindy Smith

Title

President

Phone

(435) 867-0644

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233619200000",
    "number": "1174633028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N MAIN",
            "address_2": "SUITE 203",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "84721",
            "telephone_number": "435-867-0644",
            "fax_number": "435-867-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N MAIN",
            "address_2": "SUITE 203",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "84720",
            "telephone_number": "435-867-0644",
            "fax_number": "435-867-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-02-03",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MINDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-867-0644",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "6259409921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.