Dennis L Dedecker DDS PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

135665 9924 Issued in UT

Legal business name

DENNIS L DEDECKER DDS PC

Practice address

2185 N 1700 W
#204
Layton, UT 84041-1192

Phone

(801) 773-9790

Fax

(801) 773-9792

NPI assigned

Jan 2, 2008

Organization subpart

No

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

Authorized official

Name

Dennis L Dedecker, DDS

Title

Oral and Maxillofacial Surgeon

Phone

(801) 773-9790

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Travis M. Sorensen, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Bountiful, UT
  • NPI 1679878938
  NPD (past)

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1578748190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 N 1700 W",
            "address_2": "#204",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411192",
            "telephone_number": "801-773-9790",
            "fax_number": "801-773-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 N 1700 W",
            "address_2": "#204",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840411192",
            "telephone_number": "801-773-9790",
            "fax_number": "801-773-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS L DEDECKER DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A",
        "authorized_official_last_name": "DEDECKER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ORAL AND MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "801-773-9790",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "135665  9924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECTHEALTH",
            "identifier": "107004925101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "190000851",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER#",
            "identifier": "000002181",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "52970991500001",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Layton",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Layton",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Layton",
            "address_1": "2185 N 1700 W",
            "address_2": "#204",
            "city": "Layton",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840411192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emilie Demeyer
• Adam Michael Demille
• Teri Junko Demille, PA-C, MPH, MSHS
• Dallin L Demordaunt, MD
• Don William Denning, DDS
• Taylor Denoo
• Kourtney Denovellis
• Julissa L. Depaz Carillo
• R. Ferris Derbidge, RPH
• Camille Derricott

• Oral and Maxillofacial Surgery (Dentist) in Layton, UT
• Providers in Layton, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.