Salt Lake Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5936346 Issued in UT

Legal business name

SALT LAKE DENTAL CARE

Practice address

279 E 5900 S Ste 202
Salt Lake City, UT 84107-5425

Phone

(801) 938-8855

Fax

(801) 880-9832

NPI assigned

Apr 10, 2017

Organization subpart

No

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

Authorized official

Name

Clint Blackwood, DDS

Title

Dentist

Phone

(801) 938-8855

Specialties & licenses 1

Addresses

Tax ID family

Huge Marketing2 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.

• Huge Marketing

  • Dentist
  • Murray, UT
  • NPI 1689078792
  NPD tax ID

Locations

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1437682002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 E 5900 S STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075425",
            "telephone_number": "801-938-8855",
            "fax_number": "801-880-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 E 5900 S STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075425",
            "telephone_number": "801-938-8855",
            "fax_number": "801-880-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "BLACKWOOD",
        "authorized_official_first_name": "CLINT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "801-938-8855",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5936346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salt Lake County Criminal Justice Services
• Salt Lake County Division of Substance Abuse
• Salt Lake County Division of Youth Services
• Salt Lake County Jail
• Salt Lake County Youth Services
• Salt Lake Dermatology and Aesthetics PC
• Salt Lake Donated Dental Services
• Salt Lake Endodontics
• Salt Lake Endoscopy Center
• Salt Lake Eye Associates, LLC

• General Practice Dentistry in Salt Lake City, UT
• Providers in Salt Lake City, 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 Apr 10, 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.