Mazzola Dascomb P.C.

Primary specialty

Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X

License

5860780-1205 Issued in UT

Legal business name

MAZZOLA DASCOMB P.C.

Practice address

4590 Clearview St
Holladay, UT 84117-4504

Phone

(801) 272-3799

NPI assigned

Jun 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Robert Louis Mazzola, MDNPI 1629142898

Title

President

Phone

(801) 272-3799

Specialties & licenses 4

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert L Mazzola, MD

  • Sleep Medicine (Internal Medicine) Physician
  • Salt Lake City, UT
  • NPI 1629142898
  NPD (past) Authorized official

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1306107289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 CLEARVIEW ST",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841174504",
            "telephone_number": "801-272-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 CLEARVIEW ST",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841174504",
            "telephone_number": "801-272-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAZZOLA DASCOMB P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "MAZZOLA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-272-3799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "5860780-1205",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "UT",
            "license": "5860780-1205",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "LA",
            "license": "5860780-8905",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "UT",
            "license": "5860780-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lumicare Health Ut1 LLC
• Conrad H Ma, PT, DPT
• Mary Beth Whittaker LCSW
• Michelle Maxwell
• Steiner May
• Tara McArthur, CSW
• Katharine E McCarthy, P.A.
• Jeremy Christopher McCorristin, DPT
• Paul Steven McDonough, D.D.S.
• Rebecca Ann McInnis, CNM

• Sleep Medicine (Internal Medicine) Physician in Holladay, UT
• Providers in Holladay, UT by specialty
• Sleep Medicine (Internal Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.