NPIMap

Organization Active NPI

Liddell Family Dentistry

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1346458932
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
512081-9922 Issued in UT
Legal business name
LIDDELL FAMILY DENTISTRY
Practice address
702 E South Temple Ste 209
Salt Lake City, UT 84102-1795
Phone
(801) 359-8282
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Dr. Jonathan C Liddell, DMDNPI 1104845817
Title
Partner
Phone
(801) 733-0406

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 512081-9922 UT Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 22-13695-9922 UT

Addresses

Primary practice location

702 E South Temple Ste 209
Salt Lake City, UT 84102-1795

Mailing address

702 E South Temple Ste 209
Salt Lake City, UT 84102-1795
Phone (801) 359-8282

National Provider Directory

National Provider Directory

Locations

702 E South Temple
Ste 209
Salt Lake City, UT 84102
Phone (801) 359-8282

Practitioners & affiliated clinicians

Practitioners 2

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": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1346458932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 E SOUTH TEMPLE STE 209",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021795",
            "telephone_number": "801-359-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 E SOUTH TEMPLE STE 209",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021795",
            "telephone_number": "801-359-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIDDELL FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "LIDDELL",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "801-733-0406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "512081-9922",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "22-13695-9922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.