NPIMap

Organization Active NPI

Kenneth R Dibble DDS

  • Dental Clinic/Center
  • Sandy, UT
National Provider Identifier
1336730324
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KENNETH R DIBBLE DDS
Practice address
9853 S 700 E
Sandy, UT 84070-3900
Phone
(801) 572-4430
Fax
(801) 572-5751
NPI assigned
Feb 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Authorized official

Name
Dr. Kenneth R Dibble, DDSNPI 1417935784
Title
Owner/President
Phone
(801) 572-4430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

9853 S 700 E
Sandy, UT 84070-3900

Mailing address

9853 S 700 E
Sandy, UT 84070-3900
Phone (801) 572-4430

Other practice location 1

9233 S Redwood Rd Bldg 4
West Jordan, UT 84088-5808
Phone (801) 566-0971

Other names 1

  • Lone Peak Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kenneth R Dibble DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

9233 S Redwood Rd
Bldg 4
West Jordan, UT 84088
Phone (801) 566-0971

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1336730324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9853 S 700 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703900",
            "telephone_number": "801-572-4430",
            "fax_number": "801-572-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9853 S 700 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703900",
            "telephone_number": "801-572-4430",
            "fax_number": "801-572-5751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9233 S Redwood Rd Bldg 4",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840885808",
            "country_code": "US",
            "telephone_number": "801-566-0971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KENNETH R DIBBLE DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "DIBBLE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "801-572-4430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Peak Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.