Organization Active NPI

Candid Utah, P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Draper, UT
National Provider Identifier
1558978650
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
CANDID UTAH, P.C.
Practice address
12884 S Frontrunner Blvd Ste 140
Draper, UT 84020-5488
Phone
(860) 481-7631
NPI assigned
Sep 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Authorized official

Name
Thomas Shannon
Title
DDS
Phone
(860) 481-7631

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

12884 S Frontrunner Blvd Ste 140
Draper, UT 84020-5488

Mailing address

12884 S Frontrunner Blvd Ste 140
Draper, UT 84020-5488
Phone (860) 481-7631

National Provider Directory

National Provider Directory

Locations

12884 S Frontrunner Blvd
Ste 140
Draper, UT 84020
Phone (336) 423-7697

NPI Registry JSON

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1558978650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12884 S FRONTRUNNER BLVD STE 140",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205488",
            "telephone_number": "860-481-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12884 S FRONTRUNNER BLVD STE 140",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205488",
            "telephone_number": "860-481-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDID UTAH, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "860-481-7631"
    },
    "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": []
}

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 Sep 23, 2020; 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.