Organization Active NPI

Utah Oral Surgery & Dental Implant Center

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Salt Lake City, UT
National Provider Identifier
1275899809
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
6216924-9924 Issued in UT
Legal business name
UTAH ORAL SURGERY & DENTAL IMPLANT CENTER
Practice address
6243 S Redwood Rd Ste 100
Salt Lake City, UT 84123-6408
Phone
(801) 269-1110
NPI assigned
Apr 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Authorized official

Name
Carma Nay
Title
Manager
Phone
(801) 269-1110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X 6216924-9924 UT Primary

Addresses

Primary practice location

6243 S Redwood Rd Ste 100
Salt Lake City, UT 84123-6408

Mailing address

6243 S Redwood Rd Ste 100
Salt Lake City, UT 84123-6408

National Provider Directory

National Provider Directory

Locations

6243 S Redwood Rd
Ste 100
Salt Lake Cty, UT 84123
Phone (801) 269-1110

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1275899809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6243 S REDWOOD RD STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841236408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6243 S REDWOOD RD STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841236408",
            "telephone_number": "801-269-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH ORAL SURGERY & DENTAL IMPLANT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "NAY",
        "authorized_official_first_name": "CARMA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-269-1110"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "UT",
            "license": "6216924-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.