Provo Dental Care LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PROVO DENTAL CARE LLC

Doing business as

Stonehaven Dental - Provo, LLC

Practice address

1355 N University Ave
Suite 330
Provo, UT 84604-2721

Phone

(801) 874-2451

NPI assigned

Jun 3, 2014

Last updated

Jun 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steve James

Title

Cfo

Phone

(502) 254-8504

Specialties & licenses 1

Addresses

Other names 1

• Stonehaven Dental - Provo, LLC Doing business as

Locations

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1497168975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169",
            "telephone_number": "502-254-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 N UNIVERSITY AVE",
            "address_2": "SUITE 330",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042721",
            "telephone_number": "801-874-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVO DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8504"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stonehaven Dental - Provo, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Provo City Board of Education (Provo City School District)
• Provo City Corporation (Provo City Fire/Ambulance)
• Provo City School District
• Provo Counseling Center
• Provo Counseling Center
• Provo Dialysis Center University of Utah (University of Utah)
• Provo Downtown Dental, LLC (Provo Downtown Dental)
• Provo Family Dentistry, LLC (The Dental Edge)
• Provo House of Hope
• Provo Orem Family & Cosmetic Dentistry PLLC

• Dental Clinic/Center in Provo, UT
• Providers in Provo, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.