Keith A Dodge, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7395098-9922 Issued in UT

Practice address

336 W 920 N
Orem, UT 84057-3042

Phone

(801) 225-8060

NPI assigned

Jul 7, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246924800000",
    "number": "1447489836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 W 920 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840573042",
            "telephone_number": "801-225-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 W 920 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840573042",
            "telephone_number": "801-225-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "KEITH",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2009-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "7395098-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DMB Medical PLLC
• Julie A Dobell, MD
• Thomas Dockendorf, RPH
• Doctor Reid BLLC
• Donald A. Dodge, D.D.S.
• Jeffrey Ralph Doermann, PHARMACIST
• Victor Dollar
• Emma Dominguez
• Barry Donakey
• Donald J Whittaker, DC

• General Practice Dentistry in Orem, UT
• Providers in Orem, 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 Jul 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.