Heritage Park Boulevard Dental PLLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

HERITAGE PARK BOULEVARD DENTAL PLLC

Practice address

2719 US-89
Suite 100
Ogden, UT 84404

Phone

(801) 782-5792

Fax

(801) 782-3339

NPI assigned

Oct 20, 2023

Organization subpart

No

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

Authorized official

Name

Jenny Garcia-Rocha

Title

Sr Team Lead

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Mountain View Endodontics Doing business as

Locations

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1417739715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 US-89",
            "address_2": "SUITE 100",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "84404",
            "telephone_number": "801-782-5792",
            "fax_number": "801-782-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 US-89",
            "address_2": "SUITE 100",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "84404",
            "telephone_number": "801-782-5792",
            "fax_number": "801-782-3339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 Heritage Park Blvd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840415664",
            "country_code": "US",
            "telephone_number": "801-782-5792",
            "fax_number": "801-782-3339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HERITAGE PARK BOULEVARD DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "GARCIA-ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "SR TEAM LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain View Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ada Marie Heninger, LCSW
• Sophia Henley
• Adam Archer Henrie, MD
• Amanda Henseler
• Haley Michelle Henson
• Gregorita Hernandez
• Ivonette Lindy Hernandez
• Kelsey Hernandez
• Maria Hernandez
• George Heron, EP

• Endodontics in Ogden, UT
• Providers in Ogden, UT by specialty
• Endodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.