Individual provider Active NPI

Leland V. Powell, D.D.S.

  • Pediatric Dentistry
  • West Valley City, UT
National Provider Identifier
1235255654
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
47483969923 Issued in UT
Practice address
2682 Anna Caroline Dr
West Valley City, UT 84128-5003
Phone
(801) 974-5437
Fax
(801) 964-9003
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 47483969923 UT Primary

Addresses

Primary practice location

2682 Anna Caroline Dr
West Valley City, UT 84128-5003

Mailing address

2682 Anna Caroline Dr
West Valley City, UT 84128-5003
Phone (801) 974-5437

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
47483969923UTMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Planet Tooth LLC Pediatric Dentistry CurrentSince Jun 23, 2024 Accepting new patients

Locations

2682 S Anna Caroline Dr
West Valley City, UT 84128
Phone (801) 974-5437

Organizations & group practices 1

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1235255654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2682 ANNA CAROLINE DR",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841285003",
            "telephone_number": "801-974-5437",
            "fax_number": "801-964-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2682 ANNA CAROLINE DR",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841285003",
            "telephone_number": "801-974-5437",
            "fax_number": "801-964-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "LELAND",
        "middle_name": "V.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "47483969923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.