NPIMap

Organization Active NPI

Legacy Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Layton, UT
National Provider Identifier
1487910147
Registry record updated Apr 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
8224117-9923 Issued in UT
Legal business name
LEGACY PEDIATRIC DENTISTRY, LLC
Practice address
3225 W Gordon Ave
Ste G
Layton, UT 84041-6508
Phone
(801) 544-3400
Fax
(801) 544-3402
NPI assigned
Apr 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2012

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

Authorized official

Name
Dr. Scott C Folkman, D.M.D.NPI 1144533266
Title
Owner/Principal
Phone
(801) 710-4593

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 8224117-9923 UT Primary

Addresses

Primary practice location

3225 W Gordon Ave
Ste G
Layton, UT 84041-6508

Mailing address

3225 W Gordon Ave
Ste G
Layton, UT 84041-6508
Phone (801) 544-3400

National Provider Directory

National Provider Directory

Locations

3225 W Gordon Ave
Ste G
Layton, UT 84041
Phone (801) 544-3400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333756800000",
    "number": "1487910147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 W GORDON AVE",
            "address_2": "STE G",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840416508",
            "telephone_number": "801-544-3400",
            "fax_number": "801-544-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 W GORDON AVE",
            "address_2": "STE G",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840416508",
            "telephone_number": "801-544-3400",
            "fax_number": "801-544-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-07",
        "last_updated": "2012-04-07",
        "status": "A",
        "authorized_official_last_name": "FOLKMAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PRINCIPAL",
        "authorized_official_telephone_number": "801-710-4593",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "8224117-9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2012; 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.