Stansbury Park Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

STANSBURY PARK PEDIATRIC DENTISTRY

Practice address

263 Country CLB Ste 102
Stansbury Park, UT 84074-9602

Phone

(435) 580-8800

NPI assigned

Oct 2, 2019

Organization subpart

No

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

Authorized official

Name

Alisha Shigley

Title

Office Manager

Phone

(435) 580-8800

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569974400000",
    "number": "1487295218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11996 S ANTHEM PARK BLVD STE 102",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840965643",
            "telephone_number": "435-580-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 COUNTRY CLB STE 102",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "840749602",
            "telephone_number": "435-580-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANSBURY PARK PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A",
        "authorized_official_last_name": "SHIGLEY",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "435-580-8800"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1346761152",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1811237076",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275821415",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hilary S. Seibert, DO
• Linda Rose Shober, DPT
• Stansbury Dental and Implant Center PDC PLLC
• Stansbury Park Dental Care
• Stansbury Park Orthodontics
• Stansbury Pediatric Dentistry
• Stansbury Pediatric Dentistry and Orthodontics
• Stansbury Pediatrics, Inc
• Trent Jacob Steele, ATC
• Shelby Ann Straley, RDN

• Pediatric Dentistry in Stansbury Park, UT
• Providers in Stansbury Park, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.