NPIMap

Individual provider Active NPI

Juan C. Chavez, D.M.D.

  • General Practice Dentistry
  • Orem, UT
National Provider Identifier
1295033843
Registry record updated Dec 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3104344-9922 Issued in UT
Practice address
1256 S State St
Suite 103
Orem, UT 84097-8237
Phone
(801) 224-7182
NPI assigned
Mar 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3104344-9922 UT Primary
General Practice Dentistry 1223G0001X 27894 TX

Addresses

Primary practice location

1256 S State St
Suite 103
Orem, UT 84097-8237

Mailing address

237 N 780 E
Salem, UT 84653-5532
Phone (801) 318-2289

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
3104344-9922UTMDGeneral Practice Dentistry
27894TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Ridge Dental, LLC General Practice Past Accepting new patients
John Green Dentistry PC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355011200000",
    "number": "1295033843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 N 780 E",
            "city": "SALEM",
            "state": "UT",
            "postal_code": "846535532",
            "telephone_number": "801-318-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 S STATE ST",
            "address_2": "SUITE 103",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840978237",
            "telephone_number": "801-224-7182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "JUAN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-07",
        "last_updated": "2012-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "3104344-9922",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27894",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

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