Amigos Dental Care- Marmalade District, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

AMIGOS DENTAL CARE- MARMALADE DISTRICT, LLC

Practice address

333 N 300 W
Salt Lake City, UT 84103-1215

Phone

(801) 419-0304

NPI assigned

Jun 17, 2021

Organization subpart

No

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

Authorized official

Name

Benjamin Bowman, DDS

Title

Owner/Partner

Phone

(405) 326-8004

Specialties & licenses 1

Addresses

Other names 1

• Marmalade Dentistry Doing business as

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1508435280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N 300 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841031215",
            "telephone_number": "801-419-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N 300 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841031215",
            "telephone_number": "801-419-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMIGOS DENTAL CARE- MARMALADE DISTRICT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "405-326-8004",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marmalade Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crystal Tina Marie Amezquita
• Joseph Enio Amici
• Annabelle Wilcox Amick, PA-C
• Robert Michael Amick, MD
• Amigos Dental Care- California Crossing, LLC
• Caroline Amis, LSAC
• Christina A Amore
• Zaruhi Ulikhanyan Amoros, APRN
• Amphex Pharmacy, LLC
• Kwabena Krow Ampofo

• All providers in Salt Lake City, UT
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.