Midland Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6654241-9922 Issued in UT

Legal business name

MIDLAND DENTAL

Practice address

4040 South Midland Drive
Suite 1
Roy, UT 84067

Phone

(801) 317-4407

Fax

(801) 605-8304

NPI assigned

Dec 3, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Janette Mary Allen

Title

Office Manager

Phone

(801) 317-4407

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1346542834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 SOUTH MIDLAND DRIVE",
            "address_2": "SUITE 1",
            "city": "ROY",
            "state": "UT",
            "postal_code": "84067",
            "telephone_number": "801-317-4407",
            "fax_number": "801-605-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 SOUTH MIDLAND DRIVE",
            "address_2": "SUITE 1",
            "city": "ROY",
            "state": "UT",
            "postal_code": "84067",
            "telephone_number": "801-317-4407",
            "fax_number": "801-605-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JANETTE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-317-4407",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6654241-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahnika McKinnon
• Tyler Scott McPhie, PHARMD
• Emilie Mejia
• Christon H Merkley, M.D.
• Jessica Meyers, LCSW
• Midland Pharmacy, LLC
• Mariah Miller
• Preston Scott Miller, DDS
• Scott L. Miller I, D.D.S.
• Hailey Mills

• General Practice Dentistry in Roy, UT
• Providers in Roy, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.