Active NPI
Bryan Evans Cardon, DMD
- Endodontics
- Spanish Fork, UT
National Provider Identifier
1255313680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 45
- Practice address
- 41 E 500 N
Spanish Fork, UT 84660-1515 - Phone
- (801) 504-6295
- Fax
- (801) 504-6548
- NPI assigned
- Nov 21, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5745 | OK | |
| Endodontics | 1223E0200X | 45 | OK | Primary |
| Endodontics | 1223E0200X | 9074817 | UT |
Addresses
Primary practice location
41 E 500 N
Spanish Fork, UT 84660-1515
Mailing address
41 E 500 N
Spanish Fork, UT 84660-1515
Phone (801) 504-6295
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 |
|---|---|---|---|
| 9074817 | UT | MD | Endodontist |
| 5745 | OK | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardon Endodontics PC | Endodontics | Past | 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.
-
- Endodontics
- Spanish Fork, UT
- NPI 1447652896
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410912000000",
"number": "1255313680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 E 500 N",
"city": "SPANISH FORK",
"state": "UT",
"postal_code": "846601515",
"telephone_number": "801-504-6295",
"fax_number": "801-504-6548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 E 500 N",
"city": "SPANISH FORK",
"state": "UT",
"postal_code": "846601515",
"telephone_number": "801-504-6295",
"fax_number": "801-504-6548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARDON",
"first_name": "BRYAN",
"middle_name": "EVANS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-21",
"last_updated": "2014-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "5745",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "OK",
"license": "45",
"primary": true
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "UT",
"license": "9074817",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spanish Fork, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.