Individual provider Active NPI

Jeffrey Rex Sumsion, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Park City, UT
National Provider Identifier
1396962981
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
145258-9921 Issued in UT
Practice address
4585 Silver Springs Dr
Park City, UT 84098-5913
Phone
(435) 649-0099
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 145258-9921 UT Primary

Addresses

Primary practice location

4585 Silver Springs Dr
Park City, UT 84098-5913

Mailing address

4585 Silver Springs Dr
Park City, UT 84098-5913
Phone (435) 649-0099

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
145258-9921UTMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396962981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4585 SILVER SPRINGS DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985913",
            "telephone_number": "435-649-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 SILVER SPRINGS DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985913",
            "telephone_number": "435-649-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMSION",
        "first_name": "JEFFREY",
        "middle_name": "REX",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "145258-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.