Active NPI
Timothy A. Gardner, D.M.D.
- General Practice Dentistry
- Midvale, UT
National Provider Identifier
1245363100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 361876
- Practice address
- 7001 S 900 E Ste 130
Midvale, UT 84047-1719 - Phone
- (801) 255-4421
- Fax
- (801) 562-1910
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 361876 | UT | Primary |
Addresses
Primary practice location
7001 S 900 E Ste 130
Midvale, UT 84047-1719
Mailing address
7001 S 900 E Ste 130
Midvale, UT 84047-1719
Phone (801) 255-4421
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
| License | State | Type | Specialty |
|---|---|---|---|
| 361876 | UT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Practice CD LLC | Current | Accepting new patients |
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.
-
- Dental Clinic/Center
- Layton, UT
- NPI 1841982428
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245363100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7001 S 900 E STE 130",
"city": "MIDVALE",
"state": "UT",
"postal_code": "840471719",
"telephone_number": "801-255-4421",
"fax_number": "801-562-1910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7001 S 900 E STE 130",
"city": "MIDVALE",
"state": "UT",
"postal_code": "840471719",
"telephone_number": "801-255-4421",
"fax_number": "801-562-1910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "TIMOTHY",
"middle_name": "A.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "361876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midvale, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.