NPIMap

Organization Active NPI

North Davis Pediatric Dentistry LLC

Doing business as North Davis Pediatric Dentistry

  • Pediatric Dentistry
  • Syracuse, UT
National Provider Identifier
1619764099
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
NORTH DAVIS PEDIATRIC DENTISTRY LLC
Doing business as
North Davis Pediatric Dentistry
Practice address
1792 W 1700 S Ste 101
Syracuse, UT 84075-9650
Phone
(801) 919-8880
NPI assigned
Apr 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Jason HorgesheimerNPI 1588720304
Title
Owner
Phone
(801) 919-8880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1792 W 1700 S Ste 101
Syracuse, UT 84075-9650

Mailing address

1792 W 1700 S Ste 101
Syracuse, UT 84075-9650

Other names 1

  • North Davis Pediatric Dentistry Doing business as

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": "1745193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1619764099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1792 W 1700 S STE 101",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840759650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1792 W 1700 S STE 101",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840759650",
            "telephone_number": "801-919-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH DAVIS PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "HORGESHEIMER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-919-8880"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Davis Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Syracuse, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.