NPIMap

Organization Active NPI

Access Professional Dental Care,LLC

Doing business as Blue Hills Dental

  • General Practice Dentistry
  • Riverdale, UT
National Provider Identifier
1326467168
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ACCESS PROFESSIONAL DENTAL CARE,LLC
Doing business as
Blue Hills Dental
Practice address
4115 Riverdale Rd Ste B
Riverdale, UT 84405-3509
Phone
(801) 940-5555
Fax
(385) 206-8383
NPI assigned
Apr 9, 2014
Last updated
Sep 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Authorized official

Name
Ms. Lorri Detrick
Title
Chief Operating Officer
Phone
(916) 563-6002

Specialties & licenses 1

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

Addresses

Primary practice location

4115 Riverdale Rd Ste B
Riverdale, UT 84405-3509

Mailing address

8890 Cal Center Dr
Sacramento, CA 95826-3200
Phone (916) 922-5000

Other names 1

  • Blue Hills Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Access Professional Dental Carellc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4115 Riverdale Rd
#B
Riverdale, UT 84405
Phone (801) 940-5555

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": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1326467168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8890 CAL CENTER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958263200",
            "telephone_number": "916-922-5000",
            "fax_number": "916-646-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 RIVERDALE RD STE B",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "844053509",
            "telephone_number": "801-940-5555",
            "fax_number": "385-206-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS PROFESSIONAL DENTAL CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "DETRICK",
        "authorized_official_first_name": "LORRI",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "916-563-6002",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Hills Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverdale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.