Individual provider Active NPI

Steven Phillips Blackhurst, DDS

  • Dentist
  • Lehi, UT
National Provider Identifier
1497825384
Registry record updated Jul 8, 2007
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2945039922 Issued in UT
Practice address
216 E Main St #1
Lehi, UT 84043
Phone
(801) 768-9241
Fax
(801) 768-1468
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2945039922 UT Primary

Addresses

Primary practice location

216 E Main St #1
Lehi, UT 84043

Mailing address

216 E Main St #1
Lehi, UT 84043
Phone (801) 768-9241

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160128001837 UT Order and Referring Only - DentistPractitioner - Dentist 9931402724

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2945039922UTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497825384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 E MAIN ST #1",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "84043",
            "telephone_number": "801-768-9241",
            "fax_number": "801-768-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 E MAIN ST #1",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "84043",
            "telephone_number": "801-768-9241",
            "fax_number": "801-768-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKHURST",
        "first_name": "STEVEN",
        "middle_name": "PHILLIPS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "2945039922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehi, UT

Sources for this page

Verify at the official NPI Registry.