Children'S Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

141802 Issued in UT

Legal business name

CHILDREN'S DENTISTRY

Practice address

1551 Renaissance Towne Dr
Ste 540
Bountiful, UT 84010-7667

Phone

(801) 295-8322

NPI assigned

Aug 20, 2015

Organization subpart

No

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

Authorized official

Name

Mark Lyman Nelson, DDS

Title

Dentist/Owner

Phone

(801) 295-8322

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1235505587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR",
            "address_2": "STE 540",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107667",
            "telephone_number": "801-295-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR",
            "address_2": "STE 540",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107667",
            "telephone_number": "801-295-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LYMAN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "801-295-8322",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "141802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Chan, PHARMD
• Bennett Joseph Chargo, AUD
• Melany Noemi Chavez Arias, LMSW
• Christine A Cheng, MD
• Clinton Richard Chidester, PHD
• Warren Christopher Chisler, DPT
• Choice Health Services, Inc.
• Cherilyn Christensen, APRN, FNP-C
• Hailee Christensen
• Kade Taylor Christensen, DPT

• Pediatric Dentistry in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.