Matthew Carmody, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12558925-9924 Issued in UT

Practice address

4888 S Highland Dr
Holladay, UT 84117-6007

Phone

(801) 997-1137

NPI assigned

Apr 5, 2019

Last updated

Jun 20, 2022By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1467914606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 E REDONDO AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053710",
            "telephone_number": "402-681-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4888 S HIGHLAND DR",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841176007",
            "telephone_number": "801-997-1137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7321 Balmer St Bldg 570",
            "address_purpose": "LOCATION",
            "city": "Hill AFB",
            "state": "UT",
            "postal_code": "840565012",
            "country_code": "US",
            "telephone_number": "801-777-7011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMODY",
        "first_name": "MATTHEW",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "12558925-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Holladay, UT
• Providers in Holladay, 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 Jun 20, 2022; 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.