Blue Rock Family Dental, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BLUE ROCK FAMILY DENTAL, PLLC

Practice address

1887 Aaron Dr Ste a
Tooele, UT 84074-8138

Phone

(435) 833-9900

NPI assigned

Aug 7, 2018

Last updated

Aug 7, 2018By 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

Brynn Eastman

Title

Office Manager

Phone

(435) 833-9900

Specialties & licenses 1

Addresses

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.

• Steven C Bruderer, D.M.D.

  • General Practice Dentistry
  • Tooele, UT
  • NPI 1841448008
  NPD (past)

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1326527755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 AARON DR STE A",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840748138",
            "telephone_number": "435-833-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 AARON DR STE A",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840748138",
            "telephone_number": "435-833-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ROCK FAMILY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "EASTMAN",
        "authorized_official_first_name": "BRYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "435-833-9900"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Bird
• John Lyman Bishop, DMD
• Cristi Bissegger-Cozad, APRN
• George Alva Blackburn, CMHC
• Blake R. Beazer, M.D., Inc
• Blue Willow Psychiatry
• Alyssa Bohn
• Amanda Bonacorso, BHCM
• Bonneville Mental Health
• Bonneville Mental Health, PLLC

• Dental Clinic/Center in Tooele, UT
• Providers in Tooele, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.