Active NPI
Cliff A Doman, D.M.D
- General Practice Dentistry
- Lehi, UT
National Provider Identifier
1619907086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5642987
- Practice address
- 3300 Running Creek Way
Building I
Lehi, UT 84043-5563 - Phone
- (801) 768-0404
- Fax
- (801) 766-0550
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5642987 | UT | Primary |
Addresses
Primary practice location
3300 Running Creek Way
Building I
Lehi, UT 84043-5563
Mailing address
3300 Running Creek Way
Building I
Lehi, UT 84043-5563
Phone (801) 768-0404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 272276391 | Other | UT | TAX ID# |
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 |
|---|---|---|---|
| 5642987 | UT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271203200000",
"number": "1619907086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 RUNNING CREEK WAY",
"address_2": "BUILDING I",
"city": "LEHI",
"state": "UT",
"postal_code": "840435563",
"telephone_number": "801-768-0404",
"fax_number": "801-766-0550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 RUNNING CREEK WAY",
"address_2": "BUILDING I",
"city": "LEHI",
"state": "UT",
"postal_code": "840435563",
"telephone_number": "801-768-0404",
"fax_number": "801-766-0550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMAN",
"first_name": "CLIFF",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2010-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "5642987",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID#",
"identifier": "272276391",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lehi, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.