Organization Active NPI

KCKG

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1386434280
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KCKG
Practice address
620 E 2100 S
Salt Lake City, UT 84106-1828
Phone
(801) 671-6359
NPI assigned
May 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Authorized official

Name
Dr. Kirkalnd Graham, DDS
Title
Owner
Phone
(801) 671-6359

Specialties & licenses 1

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

Addresses

Primary practice location

620 E 2100 S
Salt Lake City, UT 84106-1828

Mailing address

620 E 2100 S
Salt Lake City, UT 84106-1828
Phone (801) 671-6359

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1386434280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 E 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061828",
            "telephone_number": "801-671-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061828",
            "telephone_number": "801-671-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCKG",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "KIRKALND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-671-6359",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 May 15, 2025; 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.