NPIMap

Organization Active NPI

Prince Dental Group PLLC

  • Dentist
  • Midway, UT
National Provider Identifier
1285044206
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5923720 Issued in UT
Legal business name
PRINCE DENTAL GROUP PLLC
Practice address
210 E Main St Ste 201
Midway, UT 84049-6817
Phone
(435) 654-2822
NPI assigned
Apr 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Authorized official

Name
David Matthew PrinceNPI 1487661534
Title
Owner
Phone
(435) 654-2822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 5923720 UT Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 8006231-9922 UT

Addresses

Primary practice location

210 E Main St Ste 201
Midway, UT 84049-6817

Mailing address

210 E Main St Ste 201
Midway, UT 84049-6817

National Provider Directory

National Provider Directory

Locations

210 E Main St
Ste 201
Midway, UT 84049
Phone (435) 654-2822

Practitioners & affiliated clinicians

Practitioners 5

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": "1398729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398729600000",
    "number": "1285044206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E MAIN ST STE 201",
            "city": "MIDWAY",
            "state": "UT",
            "postal_code": "840496817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E MAIN ST STE 201",
            "city": "MIDWAY",
            "state": "UT",
            "postal_code": "840496817",
            "telephone_number": "435-654-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-04-29",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-654-2822"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "5923720",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "8006231-9922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midway, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.