Active NPI
Miranda Okubo, D.D.S
- Dentist
- Sandy, UT
National Provider Identifier
1346681244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 89605139923
- Practice address
- 7369 S Creek Rd
Sandy, UT 84093-6154 - Phone
- (801) 566-5577
- NPI assigned
- Jul 9, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 89605139923 | UT | Primary |
Addresses
Primary practice location
7369 S Creek Rd
Sandy, UT 84093-6154
Mailing address
7369 S Creek Rd
Sandy, UT 84093-6154
Phone (801) 566-5577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89605139923 | UT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifesmiles, PLLC | Current | Accepting new patients | |
| Central Fossa LLC | Dentist | Past | Accepting new patients |
Locations
7369 S Creek Rd
Sandy, UT 84093
Phone (801) 566-5577
Interoperability endpoints
- mokubo353460@direct.med.utah.edu
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405382400000",
"number": "1346681244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7369 S CREEK RD",
"city": "SANDY",
"state": "UT",
"postal_code": "840936154",
"telephone_number": "801-566-5577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7369 S CREEK RD",
"city": "SANDY",
"state": "UT",
"postal_code": "840936154",
"telephone_number": "801-566-5577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OKUBO",
"first_name": "MIRANDA",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-09",
"last_updated": "2014-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "89605139923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 15, 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.