Active NPI
Chad S Burt, DMD
- General Practice Dentistry
- Midvale, UT
National Provider Identifier
1497706386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1453659922
- Practice address
- 204 E Fort Union Blvd
Suite 101
Midvale, UT 84047 - Phone
- (801) 255-3578
- Fax
- (801) 569-8275
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1453659922 | UT | Primary |
Addresses
Primary practice location
204 E Fort Union Blvd
Suite 101
Midvale, UT 84047
Mailing address
204 E Ft Union Blvd
Suite 101
Midvale, UT 84047
Phone (801) 255-3578
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160107001679 | UT | Order and Referring Only - Dentist | 7618279688 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1453659922 | UT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K B Dentistry | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1497706386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 E FT UNION BLVD",
"address_2": "SUITE 101",
"city": "MIDVALE",
"state": "UT",
"postal_code": "84047",
"telephone_number": "801-255-3578",
"fax_number": "801-569-8275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 E FORT UNION BLVD",
"address_2": "SUITE 101",
"city": "MIDVALE",
"state": "UT",
"postal_code": "84047",
"telephone_number": "801-255-3578",
"fax_number": "801-569-8275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURT",
"first_name": "CHAD",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "1453659922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midvale, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.