Individual provider Active NPI

James Alcorn, D.M.D.

  • General Practice Dentistry
  • Highland, UT
National Provider Identifier
1316002389
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5329882 Issued in UT
Practice address
5455 W 11000 N Ste 103
Highland, UT 84003-8801
Phone
(801) 492-0055
Fax
(801) 492-0504
NPI assigned
Dec 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5329882 UT Primary

Addresses

Primary practice location

5455 W 11000 N Ste 103
Highland, UT 84003-8801

Mailing address

5455 W 11000 N Ste 103
Highland, UT 84003-8801
Phone (801) 492-0055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160112001113 UT Order and Referring Only - DentistPractitioner - Dentist 5597067215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5329882UTMDGeneral Practice Dentistry

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316002389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 W 11000 N STE 103",
            "city": "HIGHLAND",
            "state": "UT",
            "postal_code": "840038801",
            "telephone_number": "801-492-0055",
            "fax_number": "801-492-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 W 11000 N STE 103",
            "city": "HIGHLAND",
            "state": "UT",
            "postal_code": "840038801",
            "telephone_number": "801-492-0055",
            "fax_number": "801-492-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCORN",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5329882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, UT

Sources for this page

Verify at the official NPI Registry.