NPIMap

Organization Active NPI

Wise Choice Dentistry Inc.

  • General Practice Dentistry
  • Provo, UT
National Provider Identifier
1194893388
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WISE CHOICE DENTISTRY INC.
Practice address
777 N 500 W
Suite 201 B
Provo, UT 84601-1541
Phone
(801) 374-5200
Fax
(801) 375-2464
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Abraham Rodrigues
Title
Vice President
Phone
(801) 374-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

777 N 500 W
Suite 201 B
Provo, UT 84601-1541

Mailing address

777 N 500 W
Suite 201 B
Provo, UT 84601-1541
Phone (801) 374-5200

National Provider Directory

National Provider Directory

Locations

777 N 500 W
Ste 201B
Provo, UT 84601
Phone (801) 374-5100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194893388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N 500 W",
            "address_2": "SUITE 201 B",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011541",
            "telephone_number": "801-374-5200",
            "fax_number": "801-375-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N 500 W",
            "address_2": "SUITE 201 B",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011541",
            "telephone_number": "801-374-5200",
            "fax_number": "801-375-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE CHOICE DENTISTRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RODRIGUES",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "801-374-5200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.