Creek Capital Stansbury Park LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CREEK CAPITAL STANSBURY PARK LLC

Practice address

220 Millpond Ste 107
Stansbury Park, UT 84074-9760

Phone

(435) 843-5437

NPI assigned

Aug 30, 2017

Organization subpart

No

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

Authorized official

Name

Marci Nicol

Title

Coo

Phone

(801) 312-7122

Specialties & licenses 1

Addresses

Other names 1

• Burg Children's Dentistry & Orthodontics-Stansbury Park Doing business as

Locations

Practitioners 1

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

• Jeff S Burg, DDS

  • Pediatric Dentistry
  • Murray, UT
  • NPI 1033123617
  NPD (past)

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504051200000",
    "number": "1407374341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 E VINE ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075546",
            "telephone_number": "801-312-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MILLPOND STE 107",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840749760",
            "telephone_number": "435-843-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEK CAPITAL STANSBURY PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-08-30",
        "status": "A",
        "authorized_official_last_name": "NICOL",
        "authorized_official_first_name": "MARCI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "801-312-7122"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burg Children's Dentistry & Orthodontics-Stansbury Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexa Buerger
• Emily Carlson, MHA
• David J Clonts, D.D.S.
• Cameron Cooper, PA
• Cradled Soul PLLC
• Sheila Delisle
• Angela Michelle Demoss, APRN
• Dustin Dowdle, LMFT
• Curt Rydell Dustin, MSN, APRN, BC
• Families First Orthodontics

• All providers in Stansbury Park, UT
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2017; 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.