Active NPI
Mason Sullivan Wells, D.M.D.
- Dentist
- South Jordan, UT
National Provider Identifier
1659533859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7014658-9921
- Practice address
- 10393 South 1300 West
South Jordan, UT 84095 - Phone
- (801) 254-1400
- Fax
- (801) 254-7392
- NPI assigned
- Jun 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 7014658-9921 | UT | Primary |
Addresses
Primary practice location
10393 South 1300 West
South Jordan, UT 84095
Mailing address
10393 South 1300 West
South Jordan, UT 84095
Phone (801) 254-1400
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 |
|---|---|---|---|
| 7014658-9921 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683504000000",
"number": "1659533859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10393 SOUTH 1300 WEST",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "84095",
"telephone_number": "801-254-1400",
"fax_number": "801-254-7392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10393 SOUTH 1300 WEST",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "84095",
"telephone_number": "801-254-1400",
"fax_number": "801-254-7392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "MASON",
"middle_name": "SULLIVAN",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-28",
"last_updated": "2023-05-08",
"certification_date": "2023-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "7014658-9921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.