Genesis Dental of Granger

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GENESIS DENTAL OF GRANGER

Practice address

3725 W 4100 S
Suite 240
West Valley City, UT 84120-5530

Phone

(801) 965-2700

Fax

(801) 965-2701

NPI assigned

Mar 4, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Jason D Casto

Title

Member/Owner

Phone

(801) 870-0625

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.

• Jorge Samuel Quiroz, DMD

  • General Practice Dentistry
  • West Valley City, UT
  • NPI 1053872705
  NPD (past)

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1548685266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12180 S 300 E UNIT 270",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840202612",
            "telephone_number": "801-870-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 W 4100 S",
            "address_2": "SUITE 240",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205530",
            "telephone_number": "801-965-2700",
            "fax_number": "801-965-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS DENTAL OF GRANGER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "CASTO",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "801-870-0625",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Alexander Garcia, LMT
• Jeffrey Kurt Gatzemeier, PHARMD
• Heidi Genchis
• Generational Health LLC
• Generational Healthcare LLC
• Genesis Orthodontics, LLC
• Jonathan Dax Gerber, DPT
• Gerald H Geurts, PT
• Bethany Ruth Gillett, OD
• Sariah Gist

• General Practice Dentistry in West Valley City, UT
• Providers in West Valley City, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.