Wisdom Teeth Centers LLC

Primary specialty

DentistTaxonomy code 122300000X

License

341237 Issued in UT

Legal business name

WISDOM TEETH CENTERS LLC

Practice address

263 Country CLB Ste 103
Stansbury Park, UT 84074-9602

Phone

(801) 566-8833

NPI assigned

Jul 26, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Joseph S Maio, D.D.S.

Title

Owner/Dentist

Phone

(801) 566-8833

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532563200000",
    "number": "1295212884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708130",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840708130",
            "telephone_number": "801-566-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 COUNTRY CLB STE 103",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840749602",
            "telephone_number": "801-566-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDOM TEETH CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A",
        "authorized_official_last_name": "MAIO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "801-566-8833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "341237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamison Jenkins Wagner, DDS
• Adam Webster, PHARMD
• Dale Eugene Werner, LCSW
• Harley Jo Whitesides
• Michael Wild, MD
• Fei Yue Zhang, RPH

• Dentist in Stansbury Park, UT
• Providers in Stansbury Park, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.