NPIMap

Organization Active NPI

Alpine Dentists and Specialists PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Alpine, UT
National Provider Identifier
1306489059
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ALPINE DENTISTS AND SPECIALISTS PLLC
Practice address
20 W Main Street CT Ste 100
Alpine, UT 84004-1889
Phone
(801) 756-3570
NPI assigned
Oct 25, 2019
Last updated
Oct 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Authorized official

Name
Dr. Grant Stucki, DDS, MSNPI 1184850315
Title
Owner
Phone
(720) 775-5843

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X Primary

Addresses

Primary practice location

20 W Main Street CT Ste 100
Alpine, UT 84004-1889

Mailing address

20 W Main Street CT Ste 100
Alpine, UT 84004-1889
Phone (801) 756-3570

National Provider Directory

National Provider Directory

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": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571961600000",
    "number": "1306489059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W MAIN STREET CT STE 100",
            "city": "ALPINE",
            "state": "UT",
            "postal_code": "840041889",
            "telephone_number": "801-756-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W MAIN STREET CT STE 100",
            "city": "ALPINE",
            "state": "UT",
            "postal_code": "840041889",
            "telephone_number": "801-756-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE DENTISTS AND SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2019-10-25",
        "status": "A",
        "authorized_official_last_name": "STUCKI",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-775-5843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpine, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.