Thomas R Dickson, DDS., PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

264648 Issued in UT

Legal business name

THOMAS R DICKSON, DDS., PC

Practice address

714 E Fort Union Blvd
Midvale, UT 84047-2347

Phone

(801) 567-0343

Fax

(801) 566-5725

NPI assigned

Mar 24, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Thomas R Dickson, DDSNPI 1386779601

Title

President/Dentist

Phone

(801) 567-0343

Specialties & licenses 1

Addresses

Other names 1

• Creekstone Dental Doing business as

Locations

Practitioners 2

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

• Thomas R Dickson, DDS

  • Dentist
  • Midvale, UT
  • NPI 1386779601
  NPD (past) Authorized official
• Lester William Cannon, D.D.S.

  • Dentist
  • Midvale, UT
  • NPI 1326305517
  NPD (past)

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1588058960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 E FORT UNION BLVD",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472347",
            "telephone_number": "801-567-0343",
            "fax_number": "801-566-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 E FORT UNION BLVD",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472347",
            "telephone_number": "801-567-0343",
            "fax_number": "801-566-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS R DICKSON, DDS., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "801-567-0343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "264648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creekstone Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Duane Lee Tanner, O.D.
• Kaitlan Terry, MSW, CSW
• Chandra Tewari, CSW
• Paul Teynor, M.D.
• Lindsay Thielen
• Sheri L Thomas, D.V.M.
• Jenny Mariah Thompson, LCSW
• Jessica Anne Thompson
• Taralynn Thompson, CSW
• Emma Brooke Timmerman, MT-BC

• All providers in Midvale, UT
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.