Individual provider Active NPI

Matthew Richards Stohl, D.M.D.

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1205002292
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6628259 Issued in UT
Practice address
1355 Foothill Dr
Suite 100
Salt Lake City, UT 84108-2348
Phone
(801) 582-5787
Fax
(801) 582-4502
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 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 6628259 UT Primary

Addresses

Primary practice location

1355 Foothill Dr
Suite 100
Salt Lake City, UT 84108-2348

Mailing address

1355 Foothill Dr
Suite 100
Salt Lake City, UT 84108-2348
Phone (801) 582-5787

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
6628259UTMDGeneral Practice Dentistry

Networks

  • UT PPO D-SNP

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1205002292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 FOOTHILL DR",
            "address_2": "SUITE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841082348",
            "telephone_number": "801-582-5787",
            "fax_number": "801-582-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 FOOTHILL DR",
            "address_2": "SUITE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841082348",
            "telephone_number": "801-582-5787",
            "fax_number": "801-582-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOHL",
        "first_name": "MATTHEW",
        "middle_name": "RICHARDS",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6628259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.