Individual provider Active NPI

Jeffrey Trent Welch, DMD

  • General Practice Dentistry
  • Draper, UT
National Provider Identifier
1558658112
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5094305-9922 Issued in UT
Practice address
722 Bridle Pointe CV
Draper, UT 84020-7001
Phone
(801) 918-5488
NPI assigned
Jul 5, 2011
Last updated
Jul 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5094305-9922 UT Primary

Addresses

Primary practice location

722 Bridle Pointe CV
Draper, UT 84020-7001

Mailing address

722 Bridle Pointe CV
Draper, UT 84020-7001
Phone (801) 918-5488

Other identifiers 1

IdentifierTypeStateIssuer
5094305-9922OtherUTUTAH STATE DENTAL BOARD

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

LicenseStateTypeSpecialty
5094305-9922UTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1558658112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 BRIDLE POINTE CV",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207001",
            "telephone_number": "801-918-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 BRIDLE POINTE CV",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207001",
            "telephone_number": "801-918-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "JEFFREY",
        "middle_name": "TRENT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5094305-9922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH STATE DENTAL BOARD",
            "identifier": "5094305-9922",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.