Out of This World Dentistry WJ PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

144937 Issued in UT

Legal business name

OUT OF THIS WORLD DENTISTRY WJ PC

Practice address

6787 S Redwood Rd
Suite #100
West Jordan, UT 84084-2404

Phone

(801) 542-7009

Fax

(801) 748-0920

NPI assigned

Aug 20, 2014

Organization subpart

Yes

Parent organization

OUT OF THIS WORLD DENTISTRY PCAs reported in NPPES

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

Authorized official

Name

Dannielle Stark

Title

Office Manager

Phone

(801) 898-7502

Specialties & licenses 1

Addresses

Other names 1

• Out of This World Dentistry WJ Doing business as

Part of

Out of This World Dentistry PC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Out of This World Dentistry PC

  • Pediatric Dentistry
  • Draper, UT
  • NPI 1558760959
  NPPES parent name

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1336548841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6787 S REDWOOD RD",
            "address_2": "SUITE #100",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840842404",
            "telephone_number": "801-542-7009",
            "fax_number": "801-748-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6787 S REDWOOD RD",
            "address_2": "SUITE #100",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840842404",
            "telephone_number": "801-542-7009",
            "fax_number": "801-748-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUT OF THIS WORLD DENTISTRY WJ PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUT OF THIS WORLD DENTISTRY PC",
        "enumeration_date": "2014-08-20",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "DANNIELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-898-7502"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "144937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Out of This World Dentistry WJ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bret Marshall Osborne, DMD
• Darrell Osterhoudt, D.M.D., M.S.
• Genevieve Ostler
• H Gray Otis, PHD
• Ean Ottesen
• Kailee Oviatt
• Kelly A Oviatt
• Betty Jo Owen, LCSW
• Samantha Ownsbey
• Bridget Pacheco

• Pediatric Dentistry in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.