Thomas N Austad, D.D.S.

Individual provider Active NPI General Practice Dentistry · Clinton, UT

NPI 1184840779 · NPPES record last updated Jan 14, 2013

Key facts

NPI
1184840779
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6246038 (UT)
Practice address
1737 N 2000 W
Suite G
Clinton, UT 84015
Phone
(801) 728-9000
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150806011320 UT Order and Referring Only - Dentist
Practitioner - Dentist
7810201654

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6246038UTMDGeneral Practice Dentistry

Practice roles (1 of 2)

OrganizationSpecialtyStatusNew patients
Clinton Dental Group, LLP General Practice Past Accepting new patients

Networks

  • UT PPO D-SNP

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6246038 UT Yes

Addresses

Primary practice location

1737 N 2000 W
Suite G
Clinton, UT 84015

Mailing address

134 N 3300 W
Layton, UT 84041-6837

Other providers in Clinton, UT

All providers in Clinton, UT · General Practice Dentistry in Utah

Sources for this page

Verify at the official NPI Registry.