NPIMap

Organization Active NPI

Pony Express Dental of Draper, LLC

  • Dental Clinic/Center
  • Draper, UT
National Provider Identifier
1306380084
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
5015649-9923 Issued in UT
Legal business name
PONY EXPRESS DENTAL OF DRAPER, LLC
Practice address
219 E 12300 S
Suite I-5
Draper, UT 84020-6970
Phone
(801) 495-4440
Fax
(801) 495-4442
NPI assigned
Dec 14, 2016
Last updated
Dec 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Authorized official

Name
Dr. Michael S Tornow, D.M.D.NPI 1659369700
Title
Dentist Owner
Phone
(505) 947-4253

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 5015649-9923 UT Primary

Addresses

Primary practice location

219 E 12300 S
Suite I-5
Draper, UT 84020-6970

Mailing address

219 E 12300 S
Suite I-5
Draper, UT 84020-6970
Phone (801) 495-4440

National Provider Directory

National Provider Directory

Locations

219 E 12300 S
Ste I5
Draper, UT 84020
Phone (801) 495-4440

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1306380084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 E 12300 S",
            "address_2": "SUITE I-5",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840206970",
            "telephone_number": "801-495-4440",
            "fax_number": "801-495-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E 12300 S",
            "address_2": "SUITE I-5",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840206970",
            "telephone_number": "801-495-4440",
            "fax_number": "801-495-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONY EXPRESS DENTAL OF DRAPER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "TORNOW",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "505-947-4253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "UT",
            "license": "5015649-9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.