Jonathan Philip Coudron, D.D.S.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

500 Foothill Dr
Salt Lake City, UT 84148-0001

Phone

(801) 584-1206

Fax

(801) 584-5690

NPI assigned

Jun 24, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1659509966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 CONNOR ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841083007",
            "telephone_number": "804-332-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-584-1206",
            "fax_number": "801-584-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUDRON",
        "first_name": "JONATHAN",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Criste Cottrell
• Noelle Cottrell
• Danielle Lavoie Cottrill
• Logan James Couce, DPT
• Michael Francis Coudreaut, MD
• Kathleen Theresa Couillard, LCSW
• Marie F. Couldwell
• William Tupper Couldwell, MD
• Kirstin Coulombe, PT, DPT
• David M. Coulter

• Student in an Organized Health Care Education/Training Program in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Student in an Organized Health Care Education/Training Program in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; 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.