Individual provider Active NPI

John Andrew Chappell, DMD

  • General Practice Dentistry
  • West Jordan, UT
National Provider Identifier
1396236501
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-4921 Issued in ID
Practice address
7611 S Jordan Landing Blvd Ste 201
West Jordan, UT 84084-5613
Phone
(801) 280-7001
Fax
(801) 280-7076
NPI assigned
May 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D-4921 ID Primary

Addresses

Primary practice location

7611 S Jordan Landing Blvd Ste 201
West Jordan, UT 84084-5613

Mailing address

7611 S Jordan Landing Blvd Ste 201
West Jordan, UT 84084-5613
Phone (801) 280-7001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190820000946 UT Order and Referring Only - DentistPractitioner - Dentist 2668700394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-4921IDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tooth Sleuth Industries PLLC Dba Jordan Landing Dental Care General Practice CurrentSince Sep 5, 2023 Accepting new patients
Jordan Landing Dental Care, PC General Practice PastSince Sep 5, 2023 Accepting new patients

Locations

7611 S Jordan Landing Blvd
Ste 201
West Jordan, UT 84084
Phone (801) 280-7001

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1396236501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7611 S JORDAN LANDING BLVD STE 201",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845613",
            "telephone_number": "801-280-7001",
            "fax_number": "801-280-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7611 S JORDAN LANDING BLVD STE 201",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845613",
            "telephone_number": "801-280-7001",
            "fax_number": "801-280-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPPELL",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.