Leland W. Pack D.M.D., M.S. Orthodontics & Associates, Inc.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

324142-9921 Issued in UT

Legal business name

LELAND W. PACK D.M.D., M.S. ORTHODONTICS & ASSOCIATES, INC.

Practice address

1067 24TH St
Ogden, UT 84401-2758

Phone

(801) 621-5892

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Leland William Pack, D.M.D.,M.S.

Title

President

Phone

(801) 621-5892

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1285750554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 24TH ST",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844012758",
            "telephone_number": "801-621-5892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 24TH ST",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844012758",
            "telephone_number": "801-621-5892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LELAND W. PACK D.M.D., M.S. ORTHODONTICS & ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2016-09-13",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "LELAND",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-621-5892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D.,M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "324142-9921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528376102006",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Ogden, UT
• Providers in Ogden, UT by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; 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.