Midvale Modern Dentistry, LLP

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MIDVALE MODERN DENTISTRY, LLP

Practice address

1144 East Fort Union Boulevard
Midvale, UT 84047

Phone

(801) 566-3118

Fax

(801) 561-1343

NPI assigned

Apr 4, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Eric John Swensen

Title

DDS/Owner

Phone

(801) 566-3118

Specialties & licenses 1

Addresses

Other names 1

• Midvale Modern Dentistry and Orthodontics Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeri Lynn Bullock, DDS

  • General Practice Dentistry
  • Midvale, UT
  • NPI 1396030003
  NPD (past)
• Micah Weisenberg, DDS

  • Dentist
  • Midvale, UT
  • NPI 1588049233

  General Practice

  NPD (past)
• Donovan Sonny Browning, D.D.S.

  • Dentist
  • Las Vegas, NV
  • NPI 1366566960

  General Practice

  NPD (past)

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388448000000",
    "number": "1407112469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 EAST FORT UNION BOULEVARD",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "84047",
            "telephone_number": "801-566-3118",
            "fax_number": "801-561-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDVALE MODERN DENTISTRY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-04",
        "last_updated": "2013-12-31",
        "status": "A",
        "authorized_official_last_name": "SWENSEN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "801-566-3118",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midvale Modern Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica T Meninno, MD
• Whitney Jean Mentaberry, APRN
• Jessica Marie Mesquita
• Midvale City Corporation
• Midvale Family Health Clinic Inc
• Midvale PDC PLLC
• Courtney Millard
• Sarah Miller, MD, MPH
• Megan Jolley Milne, PHARM.D.
• Mind and Matter Therapy

• General Practice Dentistry in Midvale, UT
• Providers in Midvale, 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 Dec 31, 2013; 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.