Salt Lake Endodontics

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

5328713-9922 Issued in UT

Legal business name

SALT LAKE ENDODONTICS

Practice address

1955 S 1300 E Ste 6
Salt Lake City, UT 84105-3684

Phone

(801) 487-0758

Fax

(801) 487-0750

NPI assigned

Sep 19, 2008

Last updated

Sep 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mitchell G Rudd, DDSNPI 1124111323

Title

Presidient

Phone

(801) 487-0758

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, and the practitioner matching its NPPES authorized official.

• Mitchell G Rudd, DDS

  • Endodontics
  • Salt Lake City, UT
  • NPI 1124111323
  NPD (past) Authorized official

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1568612133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 S 1300 E STE 6",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053684",
            "telephone_number": "801-487-0758",
            "fax_number": "801-487-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 S 1300 E STE 6",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053684",
            "telephone_number": "801-487-0758",
            "fax_number": "801-487-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "RUDD",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDIENT",
        "authorized_official_telephone_number": "801-487-0758",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "5328713-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salt Lake County Jail
• Salt Lake County Youth Services
• Salt Lake Dental Care
• Salt Lake Dermatology and Aesthetics PC
• Salt Lake Donated Dental Services
• Salt Lake Endoscopy Center
• Salt Lake Eye Associates, LLC
• Salt Lake Family Health CNTR
• Salt Lake Foot and Ankle PLLC
• Salt Lake Homecare (Synergy Homecare)

• Endodontics in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Endodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; 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.