NPIMap

Individual provider Active NPI

Jeremy Brian Abrams, D.M.D.

  • General Practice Dentistry
  • Midvale, UT
National Provider Identifier
1336228972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4920693 Issued in UT
Practice address
942 E North Union Ave
Suite A108
Midvale, UT 84047-1764
Phone
(801) 562-2147
Fax
(801) 569-1795
NPI assigned
Nov 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 4920693 UT Primary

Addresses

Primary practice location

942 E North Union Ave
Suite A108
Midvale, UT 84047-1764

Mailing address

942 E North Union Ave
Suite A108
Midvale, UT 84047-1764
Phone (801) 562-2147

Other identifiers 2

IdentifierTypeStateIssuer
49206939901001OtherUTBLUE CROSS BLUE SHIELD
01463896OtherUTUNITED CONCORDIA

Other names 1

  • J. Brian Abrams Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4920693UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Todd S. Larsen, DMD, PC General Practice Past Accepting new patients
Fort Union Family Dental, P.C General Practice Past Accepting new patients

Organizations & group practices 2

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336228972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 E NORTH UNION AVE",
            "address_2": "SUITE A108",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471764",
            "telephone_number": "801-562-2147",
            "fax_number": "801-569-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 E NORTH UNION AVE",
            "address_2": "SUITE A108",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471764",
            "telephone_number": "801-562-2147",
            "fax_number": "801-569-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAMS",
        "first_name": "JEREMY",
        "middle_name": "BRIAN",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "4920693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "49206939901001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "01463896",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J.",
            "last_name": "ABRAMS",
            "middle_name": "BRIAN",
            "credential": "D.M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.