NPIMap

Organization Active NPI

Jody D. Boseman, DDS, LLC

  • Dentist
  • Salt Lake City, UT
National Provider Identifier
1427260280
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JODY D. BOSEMAN, DDS, LLC
Practice address
4190 South Highland Dr
Ste 106
Salt Lake City, UT 84124-2600
Phone
(801) 277-0778
Fax
(801) 278-8414
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jody D Boseman, DDSNPI 1285032011
Title
Dentist, Owner
Phone
(801) 277-0778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4190 South Highland Dr
Ste 106
Salt Lake City, UT 84124-2600

Mailing address

4190 South Highland Dr
Ste 106
Salt Lake City, UT 84124-2600
Phone (801) 277-0778

National Provider Directory

National Provider Directory

Locations

4190 S Highland Dr
Ste 106
Slc, UT 84124
Phone (801) 277-0778

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": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427260280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 SOUTH HIGHLAND DR",
            "address_2": "STE 106",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242600",
            "telephone_number": "801-277-0778",
            "fax_number": "801-278-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 SOUTH HIGHLAND DR",
            "address_2": "STE 106",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242600",
            "telephone_number": "801-277-0778",
            "fax_number": "801-278-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JODY D. BOSEMAN, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOSEMAN",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST, OWNER",
        "authorized_official_telephone_number": "801-277-0778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.