Pediatric Dental & Orthodontics PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

341292 Issued in UT

Legal business name

PEDIATRIC DENTAL & ORTHODONTICS PC

Practice address

3485 W 4800 S
Roy, UT 84067-9429

Phone

(801) 774-5437

Fax

(801) 774-9440

NPI assigned

Oct 19, 2006

Last updated

Dec 20, 2007By 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

Dr. John R. Anderson, DDS

Title

Owner

Phone

(801) 540-5081

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1184706491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3485 W 4800 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679429",
            "telephone_number": "801-774-5437",
            "fax_number": "801-774-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 W 4800 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679429",
            "telephone_number": "801-774-5437",
            "fax_number": "801-774-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL & ORTHODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-540-5081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "341292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528537398001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassidy Parkinson
• Chandice Parkinson, LCSW
• Archana Parmenter, D.O.
• Taylee Patterson
• Paul D Hopkins DDS PC
• Alison Percy
• Jetsabeth Perez Valle
• Miya Perry
• Darlene L Petersen, M.D.
• Nhi Q Pham, PA-C

• Pediatric Dentistry in Roy, UT
• Providers in Roy, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.