NPIMap

Organization Active NPI

Ut Oms Specialty Dental Services PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Salt Lake City, UT
National Provider Identifier
1407613342
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
UT OMS SPECIALTY DENTAL SERVICES PLLC
Doing business as
Utah Orthofacial Surgery
Practice address
4046 S Highland Dr Ste 112
Salt Lake City, UT 84124-1687
Phone
(801) 273-5600
NPI assigned
Mar 5, 2024
Organization subpart
Yes
Parent organization
UT OMS SPECIALTY DENTAL SERVICES PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Charlotte E Vial
Title
Director of Cred and PR
Phone
(504) 638-0303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

4046 S Highland Dr Ste 112
Salt Lake City, UT 84124-1687

Mailing address

1610 54TH Ave N Ste 205
Nashville, TN 37209-1442
Phone (615) 678-0759

Other names 1

  • Utah Orthofacial Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ut Oms Specialty Dental Services PLLC7 organizations share this tax ID, including this one
Part of
Ut Oms Specialty Dental Services PLLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6287 S Redwood Rd
Ste 103
Taylorsville, UT 84123
Phone (801) 261-2444

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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": "1709596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1407613342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "615-678-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4046 S HIGHLAND DR STE 112",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241687",
            "telephone_number": "801-273-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UT OMS SPECIALTY DENTAL SERVICES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UT OMS SPECIALTY DENTAL SERVICES PLLC",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "VIAL",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF CRED AND PR",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Utah Orthofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 5, 2024; 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.