James Farrell McConnell IV, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12180064-9921 Issued in UT

Practice address

263 Country CLB
Stansbury Park, UT 84074-9600

Phone

(435) 249-0482

NPI assigned

Mar 9, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1386239556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 COUNTRY CLB",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840749600",
            "telephone_number": "435-249-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 COUNTRY CLB",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840749600",
            "telephone_number": "435-249-0482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "399 Aria Blvd",
            "address_purpose": "LOCATION",
            "city": "Wendover",
            "state": "UT",
            "postal_code": "840834550",
            "country_code": "US",
            "telephone_number": "435-665-2962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "JAMES",
        "middle_name": "FARRELL",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "12180064-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bret Maiers, PT
• Gage Manzione, DPT
• Amber Margolis, LCSW
• Asia Roux Mazeiko, DPT
• McConnell Dental Care III
• James Farrell McConnell III, DMD
• Ashley Marie Metzger, CSW
• June Akane Mitchell, LCSW
• Anthony David Mowrey, APRN, NP, DNP, FNP
• Susan R Nate, LPC, PHD

• General Practice Dentistry in Stansbury Park, UT
• Providers in Stansbury Park, 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 Apr 7, 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.