Active NPI
Tamara Bozeman
- Dental Hygienist
- Park City, UT
National Provider Identifier
1497982185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 6234607-9920
- Practice address
- 1729 Sidewinder Dr Ste 102
Park City, UT 84060-7322 - Phone
- (435) 649-9492
- NPI assigned
- Jun 19, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6234607-9920 | UT | Primary |
Addresses
Primary practice location
1729 Sidewinder Dr Ste 102
Park City, UT 84060-7322
Mailing address
1729 Sidewinder Dr Ste 102
Park City, UT 84060-7322
Phone (435) 649-9492
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6234607-9920 | UT | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245369600000",
"number": "1497982185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1729 SIDEWINDER DR STE 102",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607322",
"telephone_number": "435-649-9492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1729 SIDEWINDER DR STE 102",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607322",
"telephone_number": "435-649-9492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOZEMAN",
"first_name": "TAMARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-19",
"last_updated": "2009-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "UT",
"license": "6234607-9920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.