Active NPI
Jeanne Ann Hibler, DDS
- Pediatric Dentistry
- Salt Lake, UT
National Provider Identifier
1609883677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 144222
- Practice address
- 1580 East 3900 South
#110
Salt Lake, UT 84124 - Phone
- (801) 272-8555
- Fax
- (801) 272-1825
- NPI assigned
- Aug 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 144222 | UT | Primary |
Addresses
Primary practice location
1580 East 3900 South
#110
Salt Lake, UT 84124
Mailing address
2549 Silver Cloud CT
Park City, UT 84060
Other names 1
- Jeanne Ann Word
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
| License | State | Type | Specialty |
|---|---|---|---|
| 144222 | UT | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creek Capital East Gate LLC | Pediatric Dentistry | Past | Accepting new patients |
| Eastgate Pediatric Dentistry | 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 and National Provider Directory roles.
-
dba Burg Children's Dentistry & Orthodontics- East Gate
- Pediatric Dentistry
- SLC, UT
- NPI 1417475344
-
- Dental Clinic/Center
- SLC, UT
- NPI 1629499520
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609883677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2549 SILVER CLOUD CT",
"city": "PARK CITY",
"state": "UT",
"postal_code": "84060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1580 EAST 3900 SOUTH",
"address_2": "#110",
"city": "SALT LAKE",
"state": "UT",
"postal_code": "84124",
"telephone_number": "801-272-8555",
"fax_number": "801-272-1825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIBLER",
"first_name": "JEANNE",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "UT",
"license": "144222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JEANNE",
"last_name": "WORD",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Salt Lake, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.