Stansbury Park Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

STANSBURY PARK ORTHODONTICS

Practice address

263 Country Club
Ste. 104
Stansbury Park, UT 84074

Phone

(435) 579-3800

Fax

(435) 579-3590

NPI assigned

Apr 23, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Timothy B Elison

Title

President

Phone

(435) 579-3800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Micah G. Mortensen, D.D.S., M.S.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Salt Lake City, UT
  • NPI 1891857579
  NPD (past)

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1528385085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 COUNTRY CLUB",
            "address_2": "STE. 104",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "84074",
            "telephone_number": "435-579-3800",
            "fax_number": "435-579-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 COUNTRY CLUB",
            "address_2": "STE. 104",
            "city": "STANSBURY PARK",
            "state": "UT",
            "postal_code": "84074",
            "telephone_number": "435-579-3800",
            "fax_number": "435-579-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANSBURY PARK ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "ELISON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-579-3800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belle Rowan-Ferris, APRN, FNP-C
• Hilary S. Seibert, DO
• Linda Rose Shober, DPT
• Stansbury Dental and Implant Center PDC PLLC
• Stansbury Park Dental Care
• Stansbury Park Pediatric Dentistry
• Stansbury Pediatric Dentistry
• Stansbury Pediatric Dentistry and Orthodontics
• Stansbury Pediatrics, Inc
• Trent Jacob Steele, ATC

• Orthodontics and Dentofacial Orthopedics Dentistry in Stansbury Park, UT
• Providers in Stansbury Park, UT by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.