Organization Active NPI

Rocky Mountain Endodontics, PLLC

  • Endodontics
  • Salt Lake City, UT
National Provider Identifier
1306421102
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
ROCKY MOUNTAIN ENDODONTICS, PLLC
Practice address
5334 S Woodrow St # 201
Salt Lake City, UT 84107-5838
Phone
(801) 833-6995
Fax
(801) 281-1980
NPI assigned
Mar 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Authorized official

Name
Dr. Randall Madsen, DDS
Title
Endodontist
Phone
(801) 942-8686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

5334 S Woodrow St # 201
Salt Lake City, UT 84107-5838

Mailing address

5334 S Woodrow St # 201
Salt Lake City, UT 84107-5838
Phone (801) 833-6995

National Provider Directory

National Provider Directory

Locations

5334 S Woodrow St
#201
Salt Lake City, UT 84107
Phone (801) 833-6995

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1306421102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5334 S WOODROW ST # 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075838",
            "telephone_number": "801-833-6995",
            "fax_number": "801-281-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5334 S WOODROW ST # 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075838",
            "telephone_number": "801-833-6995",
            "fax_number": "801-281-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN ENDODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "MADSEN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "ENDODONTIST",
        "authorized_official_telephone_number": "801-942-8686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.