Grandpas Dental Care of Utah LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

GRANDPAS DENTAL CARE OF UTAH LLC

Practice address

53 W 10600 S
Sandy, UT 84070-4160

Phone

(801) 576-1444

NPI assigned

Oct 2, 2013

Organization subpart

No

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

Authorized official

Name

Jessica Rodrigues

Title

Member

Phone

(801) 576-1444

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1215364476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 W 10600 S",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704160",
            "telephone_number": "801-576-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W 10600 S",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704160",
            "telephone_number": "801-576-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDPAS DENTAL CARE OF UTAH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "RODRIGUES",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "801-576-1444"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Scott Gordon, MD
• Debra S Gordon, R.N.
• Jennifer Gould
• Timothy E Graham, MD
• Grandpas Dental Care Inc.
• Granger Medical Clinic PC
• Granger Medical Specialists LLC
• Granite Peaks Endoscopy Surgicenter LLC
• Granite Peaks Endoscopy,LLC
• Granite Peaks Gi, LLC

• Dental Clinic/Center in Sandy, UT
• Providers in Sandy, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.