NPIMap

Organization Active NPI

MSG Dental LLC

  • Dentist
  • Provo, UT
National Provider Identifier
1255769147
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8291219 Issued in UT
Legal business name
MSG DENTAL LLC
Practice address
835 N 700 E
Provo, UT 84606
Phone
(801) 373-7700
Fax
(801) 370-0762
NPI assigned
Oct 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Todd C Groesbeck, DMD
Title
Owner
Phone
(801) 373-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 8291219 UT Primary

Addresses

Primary practice location

835 N 700 E
Provo, UT 84606

Mailing address

835 N 700 E
Provo, UT 84606
Phone (801) 373-7700

Other names 1

  • Cougar Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cougar Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1255769147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 N 700 E",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84606",
            "telephone_number": "801-373-7700",
            "fax_number": "801-370-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 N 700 E",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84606",
            "telephone_number": "801-373-7700",
            "fax_number": "801-370-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSG DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GROESBECK",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-373-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "8291219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cougar Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.