Eagle Mountain Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

4931937 Issued in UT

Legal business name

EAGLE MOUNTAIN DENTAL, LLC

Practice address

30 E 700 S
Brigham City, UT 84302-3235

Phone

(435) 734-2248

Fax

(435) 723-0778

NPI assigned

Jul 24, 2017

Organization subpart

No

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

Authorized official

Name

Mark Murdock, DDSNPI 1104862275

Title

Owner

Phone

(435) 734-2248

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brigham City Smiles 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.

• Mark Brooks Murdock, D.D.S

  • General Practice Dentistry
  • Brigham City, UT
  • NPI 1104862275
  NPD (past) Authorized official
• William Alexander Crow, DDS

  • General Practice Dentistry
  • Brigham City, UT
  • NPI 1780516138
  NPD (past)

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1649793407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 700 S",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023235",
            "telephone_number": "435-734-2248",
            "fax_number": "435-723-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 700 S",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023235",
            "telephone_number": "435-734-2248",
            "fax_number": "435-723-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MOUNTAIN DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MURDOCK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-734-2248",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "4931937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTIST",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brigham City Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hayli Dubois
• Keely Duell
• Madison Dumont
• Tina Dunford, CNA
• Kevin Dyslin
• Cory Eddington, M.S., LMFT
• James Scot Edelman, PH.D.
• Anthony Edlefsen
• Chrispen Edwards
• Zachary John Egan

• Dentist in Brigham City, UT
• Providers in Brigham City, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.