Brendon Thueson Tingey, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

12797324-9923 Issued in UT

Practice address

11501 S 4000 W Ste 101
South Jordan, UT 84009-6028

Phone

(801) 701-2120

NPI assigned

Jun 14, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Brendon Thueson Tingey Professional name

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dentists of South Jordan, LLP

  • General Practice Dentistry
  • South Jordan, UT
  • NPI 1700391828
  NPD (past)
• Heritage Dental LLC

  • General Practice Dentistry
  • Waverly, IA
  • NPI 1154574846
  NPD (past)

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1649848904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14407 MURDOCK PEAK DR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840961855",
            "telephone_number": "801-792-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11501 S 4000 W STE 101",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840096028",
            "telephone_number": "801-701-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 10th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Waverly",
            "state": "IA",
            "postal_code": "506773752",
            "country_code": "US",
            "telephone_number": "319-352-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TINGEY",
        "first_name": "BRENDON",
        "middle_name": "THUESON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "12797324-9923",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDON",
            "last_name": "TINGEY",
            "middle_name": "THUESON",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Thrive Recovery
• Vilate M Thur, APRN
• Jana Dickson Tibbitts
• Emily Tieu
• Timber Peaks Medical LLC
• Lindsey Tirmenstein, BCABA
• Clinton H Todd, CMHC INTERN
• Togo Acute and Post Acute Care
• Togo Healthcare LLC
• Sarah Beth Patience Tolman

• Dentist in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.