Individual provider Active NPI

Jeremy Merrill Felt, D.D.S.

  • General Practice Dentistry
  • Roy, UT
National Provider Identifier
1235147372
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5333398-9922 Issued in UT
Practice address
2779 W. 4000 S. Suite 102
Roy, UT 84067-9429
Phone
(801) 774-9354
Fax
(801) 774-6430
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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 5333398-9922 UT Primary

Addresses

Primary practice location

2779 W. 4000 S. Suite 102
Roy, UT 84067-9429

Mailing address

2779 W. 4000 S. Suite 102
Roy, UT 84067-9429
Phone (801) 776-4462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160422000871 UT Order and Referring Only - DentistPractitioner - Dentist 2961701115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1235147372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2779 W. 4000 S. SUITE 102",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679429",
            "telephone_number": "801-776-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2779 W. 4000 S. SUITE 102",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679429",
            "telephone_number": "801-774-9354",
            "fax_number": "801-774-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELT",
        "first_name": "JEREMY",
        "middle_name": "MERRILL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5333398-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roy, UT

Sources for this page

Verify at the official NPI Registry.