Organization Active NPI

I Smile at Crossroads Dental Group

  • General Practice Dentistry
  • Riverton, UT
National Provider Identifier
1578972592
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
I SMILE AT CROSSROADS DENTAL GROUP
Practice address
3409 W 12600 S
100
Riverton, UT 84065-7260
Phone
(801) 561-1559
NPI assigned
Aug 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Authorized official

Name
Lara Johnson
Title
Insurance Coordinator
Phone
(801) 561-1559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3409 W 12600 S
100
Riverton, UT 84065-7260

Mailing address

3409 W 12600 S
100
Riverton, UT 84065-7260

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1578972592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 W 12600 S",
            "address_2": "100",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 W 12600 S",
            "address_2": "100",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657260",
            "telephone_number": "801-561-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I SMILE AT CROSSROADS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LARA",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "801-561-1559"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.