NPIMap

Organization Active NPI

Millcreek Anesthesia PC

  • Anesthesiology Physician
  • Salt Lake City, UT
National Provider Identifier
1306879820
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MILLCREEK ANESTHESIA PC
Practice address
1200 E 3900 S
Salt Lake City, UT 84124-1300
Phone
(801) 727-2060
NPI assigned
Jul 8, 2006
Last updated
Jun 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Timothy DanceNPI 1811135981
Title
President
Phone
(801) 581-2121

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
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

1200 E 3900 S
Salt Lake City, UT 84124-1300

Mailing address

PO Box 3690
Salt Lake City, UT 84110-3690
Phone (801) 727-2060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000147 UT Part B Supplier - Clinic/Group Practice 0840194643 Receives reassigned benefits from 54 practitioners
Practice locations: Draper, UT; Salt Lake City, UT

National Provider Directory

National Provider Directory

Locations

1954 E Fort Union Blvd
Ste 104
Salt Lake Cty, UT 84121
Phone (801) 993-9530

Practitioners & affiliated clinicians

Practitioners 64

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.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1306879820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3690",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103690",
            "telephone_number": "801-727-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241300",
            "telephone_number": "801-727-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLCREEK ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "DANCE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-581-2121"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "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 Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.