Basin Family Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

142333-9922 Issued in UT

Legal business name

BASIN FAMILY DENTISTRY, PC

Practice address

209 W 200 N
71-2
Roosevelt, UT 84066-2835

Phone

(435) 722-2111

Fax

(435) 722-2005

NPI assigned

Dec 27, 2006

Last updated

Sep 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gregory George Page, DDSNPI 1447624325

Title

President

Phone

(435) 722-2111

Specialties & licenses 1

Addresses

Other names 1

• Gregory G. Page, DDS, PC Former legal business name

Locations

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.

• Gregory George Page, DDS

  • Dentist
  • Roosevelt, UT
  • NPI 1447624325

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1306901566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W 200 N",
            "address_2": "71-2",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662835",
            "telephone_number": "435-722-2111",
            "fax_number": "435-722-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W 200 N",
            "address_2": "71-2",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662835",
            "telephone_number": "435-722-2111",
            "fax_number": "435-722-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASIN FAMILY DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-722-2111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "142333-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gregory G. Page, DDS, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ryan James Avery, MOTR/L
• Jordan R Baadsgaard, P.T.
• Jannell Barker
• Bonnie J Barnes, RN
• Basin Family Dental LLC
• Basin Family Pharmacy
• Basin Therapy LLC
• Vail Shanae Batty, RN
• Kerry Robert Baum Jr., MD
• Garrison Douglas Beach, PA

• General Practice Dentistry in Roosevelt, UT
• Providers in Roosevelt, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.