NPIMap

Individual provider Active NPI

Bryan Glen Greenwood, D.D.S.

  • Dentist
  • Saratoga Springs, UT
National Provider Identifier
1578901674
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8669892 Issued in UT
Practice address
76 E Commerce Dr
Suite 101
Saratoga Springs, UT 84045-4022
Phone
(801) 766-3269
Fax
(801) 766-3272
NPI assigned
Jun 11, 2013
Last updated
Jun 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8669892 UT Primary

Addresses

Primary practice location

76 E Commerce Dr
Suite 101
Saratoga Springs, UT 84045-4022

Mailing address

76 E Commerce Dr
Suite 101
Saratoga Springs, UT 84045-4022
Phone (801) 766-3269

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
8669892UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwood Dental Past Accepting new patients
Greenwood Dental Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1578901674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 E COMMERCE DR",
            "address_2": "SUITE 101",
            "city": "SARATOGA SPRINGS",
            "state": "UT",
            "postal_code": "840454022",
            "telephone_number": "801-766-3269",
            "fax_number": "801-766-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 E COMMERCE DR",
            "address_2": "SUITE 101",
            "city": "SARATOGA SPRINGS",
            "state": "UT",
            "postal_code": "840454022",
            "telephone_number": "801-766-3269",
            "fax_number": "801-766-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWOOD",
        "first_name": "BRYAN",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "8669892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.