Active NPI
Nicolas Shane Stapleton, DMD
- Dentist
- Provo, UT
National Provider Identifier
1649967068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 13357463-9923
- Practice address
- 2255 N University Pkwy Ste 37
Provo, UT 84604-1503 - Phone
- (801) 386-8778
- NPI assigned
- Apr 18, 2023
- Last updated
- Apr 20, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 13357463-9923 | UT | Primary |
Addresses
Primary practice location
2255 N University Pkwy Ste 37
Provo, UT 84604-1503
Mailing address
1033 S 750 W
American Fork, UT 84003-4541
Phone (949) 633-9994
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 |
|---|---|---|---|
| 13357463-9923 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681948800000",
"number": "1649967068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1033 S 750 W",
"city": "AMERICAN FORK",
"state": "UT",
"postal_code": "840034541",
"telephone_number": "949-633-9994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2255 N UNIVERSITY PKWY STE 37",
"city": "PROVO",
"state": "UT",
"postal_code": "846041503",
"telephone_number": "801-386-8778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAPLETON",
"first_name": "NICOLAS",
"middle_name": "SHANE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-18",
"last_updated": "2023-04-20",
"certification_date": "2023-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "13357463-9923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.