Canyon River Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

312434 Issued in UT

Legal business name

CANYON RIVER DENTAL

Practice address

3707 N Canyon Rd Ste 7D
Provo, UT 84604-4586

Phone

(801) 221-5859

Fax

(801) 221-7091

NPI assigned

Mar 30, 2009

Last updated

Mar 30, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Traci M Franc

Title

Manager

Phone

(801) 221-5859

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Canyon River Dental3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Canyon River Dental

  • General Practice Dentistry
  • Provo, UT
  • NPI 1306277546
  NPD tax ID
• Canyon River Dental

  • Dentist
  • Provo, UT
  • NPI 1821196197
  NPD tax ID

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1306088836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 N CANYON RD STE 7D",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044586",
            "telephone_number": "801-221-5859",
            "fax_number": "801-221-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 N CANYON RD STE 7D",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044586",
            "telephone_number": "801-221-5859",
            "fax_number": "801-221-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON RIVER DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "FRANC",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-221-5859",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "UT",
            "license": "312434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529578391004",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Suzan Canty
• Canyon Counseling Center, Inc
• Canyon Crest Optical
• Canyon Pharmaceutical, LLC (Rock Canyon Pharmacy)
• Canyon Ridge Psychology LLC
• Canyon River Dental
• Canyon River Dental
• Canyon Road Dental PLLC (Canyon Road Dental)
• Canyon View Medical Group LLC (Canyon View Womens Care Provo)
• Canyonview Family Practice

• Dental Clinic/Center in Provo, UT
• Providers in Provo, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.