Genesis Dental of Tooele, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GENESIS DENTAL OF TOOELE, LLC

Practice address

1204 N Main St
Tooele, UT 84074-9540

Phone

(435) 882-8600

Fax

(435) 882-8605

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jason D Casto

Title

Owner/Member

Phone

(801) 838-8030

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• John Lyman Bishop, DMD

  • General Practice Dentistry
  • Tooele, UT
  • NPI 1538103544
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629188172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6087 S REDWOOD RD",
            "address_2": "SUITE C",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841235330",
            "telephone_number": "801-838-8030",
            "fax_number": "801-352-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840749540",
            "telephone_number": "435-882-8600",
            "fax_number": "435-882-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS DENTAL OF TOOELE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASTO",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "801-838-8030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Gallen
• Ana Garcia, LMT
• Jessica Renee Garcia, MFT
• Kylie Gardner
• General Surgery at Northpointe, LLC
• Gentle Care LLC
• Marshall Rex Gibson, PA-C
• Laura Gifford, RPH
• Sarah Gill, PA-C
• Lamar J Gillen, LPC

• General Practice Dentistry in Tooele, UT
• Providers in Tooele, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.