Active NPI
Fernando Fittipaldi Pessoa, D.D.S
- General Practice Dentistry
- Draper, UT
National Provider Identifier
1659502607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7391760
- Practice address
- 949 Pioneer Rd
A-2
Draper, UT 84020-8200 - Phone
- (801) 921-9239
- NPI assigned
- Aug 6, 2009
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7391760 | UT | Primary |
Addresses
Primary practice location
949 Pioneer Rd
A-2
Draper, UT 84020-8200
Mailing address
949 Pioneer Rd
A-2
Draper, UT 84020-8200
Phone (801) 921-9239
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 |
|---|---|---|---|
| 7391760 | UT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249516800000",
"number": "1659502607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "949 PIONEER RD",
"address_2": "A-2",
"city": "DRAPER",
"state": "UT",
"postal_code": "840208200",
"telephone_number": "801-921-9239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "949 PIONEER RD",
"address_2": "A-2",
"city": "DRAPER",
"state": "UT",
"postal_code": "840208200",
"telephone_number": "801-921-9239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PESSOA",
"first_name": "FERNANDO",
"middle_name": "FITTIPALDI",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-06",
"last_updated": "2009-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "7391760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.