NPIMap

Organization Active NPI

Kim G. Roberts DDS

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1346536653
Registry record updated Jun 24, 2011
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
142369 Issued in UT
Legal business name
KIM G. ROBERTS DDS
Practice address
4046 Highland Dr
#114
Salt Lake City, UT 84124-1673
Phone
(801) 424-3500
NPI assigned
Jun 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Authorized official

Name
Mrs. Elaine Lowry
Title
Office Manager
Phone
(801) 424-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 142369 UT Primary

Addresses

Primary practice location

4046 Highland Dr
#114
Salt Lake City, UT 84124-1673

Mailing address

4046 Highland Dr
#114
Salt Lake City, UT 84124-1673
Phone (801) 424-3500

National Provider Directory

National Provider Directory

Locations

4046 S Highland Dr
Ste 114
Salt Lake City, UT 84124
Phone (801) 424-3500

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1346536653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4046 HIGHLAND DR",
            "address_2": "#114",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241673",
            "telephone_number": "801-424-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4046 HIGHLAND DR",
            "address_2": "#114",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241673",
            "telephone_number": "801-424-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM G. ROBERTS DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "LOWRY",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-424-3500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "142369",
            "primary": true
        }
    ],
    "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 Jun 24, 2011; 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.