NPIMap

Organization Active NPI

Stobbe Eggett Dental

Doing business as Bountiful Dentistry

  • Dental Clinic/Center
  • Bountiful, UT
National Provider Identifier
1417484163
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
4923271 Issued in UT
Legal business name
STOBBE EGGETT DENTAL
Doing business as
Bountiful Dentistry
Practice address
625 E 500 S
Suite 201
Bountiful, UT 84010-3882
Phone
(801) 292-0443
NPI assigned
May 12, 2017
Last updated
May 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Authorized official

Name
Suzie Henry
Title
Office Manager
Phone
(801) 292-0443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 4923271 UT Primary

Addresses

Primary practice location

625 E 500 S
Suite 201
Bountiful, UT 84010-3882

Mailing address

625 E 500 S
Suite 201
Bountiful, UT 84010-3882
Phone (801) 292-0443

Other names 1

  • Bountiful Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bountiful Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494547200000",
    "number": "1417484163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E 500 S",
            "address_2": "SUITE 201",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840103882",
            "telephone_number": "801-292-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E 500 S",
            "address_2": "SUITE 201",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840103882",
            "telephone_number": "801-292-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOBBE EGGETT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-12",
        "last_updated": "2017-05-12",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "SUZIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-292-0443"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "UT",
            "license": "4923271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bountiful Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.