M Kelly Soutas DMD PC

Primary specialty

DentistTaxonomy code 122300000X

License

374892 Issued in UT

Legal business name

M KELLY SOUTAS DMD PC

Doing business as

A Place To Smile

Practice address

485 S Main St
Ste 302
Springville, UT 84663-2279

Phone

(801) 489-6811

Fax

(801) 489-6840

NPI assigned

Sep 8, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Michael Kelly Soutas, DMD

Title

President

Phone

(801) 489-6811

Specialties & licenses 2

Addresses

Other names 1

• A Place To Smile Doing business as

Locations

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441670400000",
    "number": "1316315369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 S MAIN ST",
            "address_2": "STE 302",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846632279",
            "telephone_number": "801-489-6811",
            "fax_number": "801-489-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 S MAIN ST",
            "address_2": "STE 302",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846632279",
            "telephone_number": "801-489-6811",
            "fax_number": "801-489-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M KELLY SOUTAS DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-08",
        "last_updated": "2015-09-08",
        "status": "A",
        "authorized_official_last_name": "SOUTAS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-489-6811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "374892",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Place To Smile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Springville, UT
• Providers in Springville, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.