NPIMap

Organization Active NPI

Out of This World Dentistry PC

  • Pediatric Dentistry
  • Draper, UT
National Provider Identifier
1558760959
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
144937 Issued in UT
Legal business name
OUT OF THIS WORLD DENTISTRY PC
Practice address
112 E 12450 S Ste 100
Draper, UT 84020-8057
Phone
(801) 571-6751
Fax
(801) 571-4156
NPI assigned
Aug 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Authorized official

Name
Dannielle Stark
Title
Office Manager
Phone
(801) 898-7502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 144937 UT Primary

Addresses

Primary practice location

112 E 12450 S Ste 100
Draper, UT 84020-8057

Mailing address

112 E 12450 S Ste 100
Draper, UT 84020-8057
Phone (801) 571-6751

Other names 1

  • Out of This World Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Out of This World Dentistry PC2 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.

Locations

112 E 12450 S
Ste 100
Draper, UT 84020
Phone (801) 571-6751

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1558760959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E 12450 S STE 100",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208057",
            "telephone_number": "801-571-6751",
            "fax_number": "801-571-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 12450 S STE 100",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208057",
            "telephone_number": "801-571-6751",
            "fax_number": "801-571-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUT OF THIS WORLD DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "DANNIELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-898-7502"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "144937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Out of This World Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 21, 2014; 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.