Park City Pediatric Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PARK CITY PEDIATRIC DENTISTRY

Practice address

1901 Prospector Ave
Park City, UT 84060-7207

Phone

(435) 649-5001

NPI assigned

Dec 19, 2013

Organization subpart

No

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

Authorized official

Name

Marci Nicol

Title

VP of Operations

Phone

(801) 918-4135

Specialties & licenses 1

Addresses

Tax ID family

Park City Pediatric Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Park City Pediatric Dentistry

  • Pediatric Dentistry
  • Park City, UT
  • NPI 1558516161
  NPD tax ID

Locations

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387411200000",
    "number": "1508287475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 PROSPECTOR AVE",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607207",
            "telephone_number": "435-649-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 PROSPECTOR AVE",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607207",
            "telephone_number": "435-649-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK CITY PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-19",
        "last_updated": "2013-12-19",
        "status": "A",
        "authorized_official_last_name": "NICOL",
        "authorized_official_first_name": "MARCI",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "801-918-4135"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park City Imaging, Inc.
• Park City Internal Medicine - Pediatrics, LC
• Park City Market Inc (The Market Pharmacy)
• Park City Medical Center
• Park City PDC PLLC (Snow Country Dental Care)
• Park City Pediatric Dentistry
• Park City Surgery Center LLC
• Park City Vision Center, Inc.
• Katharine Parker, RDN, CNSC, CD
• Kathleen Parker, LCSW

• Dental Clinic/Center in Park City, UT
• Providers in Park City, 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 Dec 19, 2013; 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.