Individual provider Active NPI

Preston Robert Dahlgren, MFT

  • Marriage & Family Therapist
  • South Jordan, UT
National Provider Identifier
1275123077
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
7240205-3902 Issued in UT
Practice address
10808 S River Front Pkwy Ste 361
South Jordan, UT 84095-6300
Phone
(801) 900-6047
NPI assigned
Jan 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 7240205-3902 UT Primary

Addresses

Primary practice location

10808 S River Front Pkwy Ste 361
South Jordan, UT 84095-6300

Mailing address

10808 S River Front Pkwy Ste 361
South Jordan, UT 84095-6300
Phone (801) 900-6047

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

LicenseStateTypeSpecialty
7240205-3902UTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1275123077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10808 S RIVER FRONT PKWY STE 361",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840956300",
            "telephone_number": "801-900-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10808 S RIVER FRONT PKWY STE 361",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840956300",
            "telephone_number": "801-900-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLGREN",
        "first_name": "PRESTON",
        "middle_name": "ROBERT",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "7240205-3902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.