Genesis Dental of South Jordan

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GENESIS DENTAL OF SOUTH JORDAN

Doing business as

Genesis Dental at The District

Practice address

11531 S District Dr Ste 600
South Jordan, UT 84095-5782

Phone

(801) 254-7272

Fax

(801) 254-6565

NPI assigned

Oct 16, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Jason David Casto

Title

Member/Owner

Phone

(801) 870-0625

Specialties & licenses 1

Addresses

Other names 2

• Genesis Dental at The District Doing business as
• Genesis Dental of Riverton Former legal business name

Locations

Practitioners 1

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

• Timothy S Heward, D.D.S

  • General Practice Dentistry
  • Montrose, CO
  • NPI 1427252386
  NPD (past)

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

{
    "created_epoch": "1413417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1427452614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12180 S 300 E UNIT 270",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840202612",
            "telephone_number": "801-870-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11531 S DISTRICT DR STE 600",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955782",
            "telephone_number": "801-254-7272",
            "fax_number": "801-254-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS DENTAL OF SOUTH JORDAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-16",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "CASTO",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "801-870-0625",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Dental at The District",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Genesis Dental at The District",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Genesis Dental of Riverton",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kathy Stretch Garcia, MD
• Patrick Wayne Garcia, D.C.
• Alex Joseph Gardner, DDS
• Thayne Henrie Gardner, DDS
• Chuck Hung Gee, PA-C
• Jonathan Wesley George, PHARMD.
• Gerardo F. Maymi, D.M.D. PC
• Angela Elizabeth Gerritsen
• Kelsee Geurts
• Amberli Geverts

• General Practice Dentistry in South Jordan, UT
• Providers in South Jordan, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.