NPIMap

Organization Active NPI

San Juan Dental

  • General Practice Dentistry
  • Monticello, UT
National Provider Identifier
1447465141
Registry record updated Jan 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
360185 Issued in UT
Legal business name
SAN JUAN DENTAL
Practice address
217 S. 100 W.
Monticello, UT 84535
Phone
(435) 587-2528
Fax
(435) 587-3585
NPI assigned
May 14, 2007
Last updated
Jan 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2009

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

Authorized official

Name
Dr. Gerald O. Miller, DDS
Title
Dentist
Phone
(435) 587-2528

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 139310 UT
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 360185 UT Primary

Addresses

Primary practice location

217 S. 100 W.
Monticello, UT 84535

Mailing address

PO Box 760
Monticello, UT 84535-0760
Phone (435) 587-2528

National Provider Directory

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": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232582400000",
    "number": "1447465141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 760",
            "city": "MONTICELLO",
            "state": "UT",
            "postal_code": "845350760",
            "telephone_number": "435-587-2528",
            "fax_number": "435-587-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 S. 100 W.",
            "city": "MONTICELLO",
            "state": "UT",
            "postal_code": "84535",
            "telephone_number": "435-587-2528",
            "fax_number": "435-587-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2009-01-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "435-587-2528",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "139310",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "360185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.