Cache Valley Dental Associates LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CACHE VALLEY DENTAL ASSOCIATES LLC

Practice address

120 W Cache Valley Blvd Ste 200
Logan, UT 84341-2697

Phone

(435) 753-7563

NPI assigned

Apr 15, 2019

Organization subpart

No

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

Authorized official

Name

Anthony Larson, DDS

Title

Owner/Registered Agent

Phone

(435) 232-1232

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555286400000",
    "number": "1295398352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2797 N HIGHWAY 89 STE 300",
            "city": "PLEASANT VIEW",
            "state": "UT",
            "postal_code": "844041232",
            "telephone_number": "801-786-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W CACHE VALLEY BLVD STE 200",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412697",
            "telephone_number": "435-753-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CACHE VALLEY DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-04-15",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/REGISTERED AGENT",
        "authorized_official_telephone_number": "435-232-1232",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Logan, UT
• Providers in Logan, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.