Individual provider Active NPI

Matthew Melvin Griffeth, D.M.D.

  • General Practice Dentistry
  • Park City, UT
National Provider Identifier
1194992586
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61813279922 Issued in UT
Practice address
1680 Ute Blvd
Suite B
Park City, UT 84098-7634
Phone
(435) 647-3012
Fax
(435) 645-9873
NPI assigned
May 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61813279922 UT Primary

Addresses

Primary practice location

1680 Ute Blvd
Suite B
Park City, UT 84098-7634

Mailing address

PO Box 980367
Park City, UT 84098-0367
Phone (435) 647-3012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61813279922UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
G&G Dental PLLC Past Accepting new patients
Signature Utah Dental Partners PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1194992586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980367",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840980367",
            "telephone_number": "435-647-3012",
            "fax_number": "435-645-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 UTE BLVD",
            "address_2": "SUITE B",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840987634",
            "telephone_number": "435-647-3012",
            "fax_number": "435-645-9873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFETH",
        "first_name": "MATTHEW",
        "middle_name": "MELVIN",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "61813279922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.