Great Smiles Dental Clinic LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9030705 Issued in UT

Legal business name

GREAT SMILES DENTAL CLINIC LLC

Practice address

7410 S Creek Rd
#303
Sandy, UT 84093-6140

Phone

(801) 642-4080

NPI assigned

Nov 6, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Joshua Rodriggs

Title

GMP

Phone

(385) 355-1434

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446768000000",
    "number": "1447623830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E MAIN ST",
            "address_2": "#351",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840434200",
            "telephone_number": "801-642-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 S CREEK RD",
            "address_2": "#303",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936140",
            "telephone_number": "801-642-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT SMILES DENTAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-06",
        "last_updated": "2015-11-06",
        "status": "A",
        "authorized_official_last_name": "RODRIGGS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "GMP",
        "authorized_official_telephone_number": "385-355-1434",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "9030705",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "135181",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Granite Peaks Pathology P.C.
• Granite Peaks Surgicenter, LLC
• Brydon J.B. Grant, M.D.
• Alexis Rose Gratton
• Elizabeth Louise Gray, ACMHC
• Daniel Green
• Heather Green, L.C.S.W.
• Jolene M Green, LCSW
• Michelle H Greene, LCSW
• Colin Reed Greer, PT, DPT

• All providers in Sandy, UT
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.