NPIMap

Organization Active NPI

St George Kids Dental, PLLC

  • Pediatric Dentistry
  • St George, UT
National Provider Identifier
1275958191
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
8669834-9923 Issued in UT
Legal business name
ST GEORGE KIDS DENTAL, PLLC
Practice address
446 S Mall Dr Unit 100
St George, UT 84790-4944
Phone
(208) 329-4580
NPI assigned
Mar 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Authorized official

Name
Trent Pryor, DMD
Title
Member
Phone
(208) 329-4580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 8669834-9923 UT Primary

Addresses

Primary practice location

446 S Mall Dr Unit 100
St George, UT 84790-4944

Mailing address

446 S Mall Dr Unit 100
St George, UT 84790-4944

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1393632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1275958191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 S MALL DR UNIT 100",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 S MALL DR UNIT 100",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904944",
            "telephone_number": "208-329-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST GEORGE KIDS DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-01",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "PRYOR",
        "authorized_official_first_name": "TRENT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "208-329-4580",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "8669834-9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.

Verify at the official NPI Registry.