NPIMap

Organization Active NPI

K B Dentistry

  • General Practice Dentistry
  • Midvale, UT
National Provider Identifier
1265037014
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
K B DENTISTRY
Practice address
204 East Fort Union Blvd, Suite 101
Midvale, UT 84047
Phone
(801) 255-3578
Fax
(801) 210-7628
NPI assigned
Dec 1, 2020
Last updated
Dec 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Dr. Kyle W. Dimond, DDS
Title
Dentist
Phone
(801) 255-3578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

204 East Fort Union Blvd, Suite 101
Midvale, UT 84047

Mailing address

204 East Fort Union Blvd, Suite 101
Midvale, UT 84047
Phone (801) 255-3578

National Provider Directory

National Provider Directory

Locations

204 E Fort Union Blvd
Ste 101
Midvale, UT 84047
Phone (801) 255-3578

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1265037014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 EAST FORT UNION BLVD, SUITE 101",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "84047",
            "telephone_number": "801-255-3578",
            "fax_number": "801-210-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 EAST FORT UNION BLVD, SUITE 101",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "84047",
            "telephone_number": "801-255-3578",
            "fax_number": "801-210-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K B DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "DIMOND",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "801-255-3578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 Dec 1, 2020; 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.