NPIMap

Organization Active NPI

Kyle S Christensen, DDS, PC

Doing business as Wasatch Oral Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • South Jordan, UT
National Provider Identifier
1669662425
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
KYLE S CHRISTENSEN, DDS, PC
Doing business as
Wasatch Oral Surgery
Practice address
1268 W South Jordan Pkwy
Suite 200
South Jordan, UT 84095-4652
Phone
(801) 561-8088
Fax
(801) 562-8286
NPI assigned
Jul 27, 2007
Last updated
Jul 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Authorized official

Name
Kyle S Christensen, D.D.S.NPI 1194837625
Title
Owner
Phone
(801) 561-8088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

1268 W South Jordan Pkwy
Suite 200
South Jordan, UT 84095-4652

Mailing address

1268 W South Jordan Pkwy
Suite 200
South Jordan, UT 84095-4652
Phone (801) 561-8088

Other names 1

  • Wasatch Oral Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

1268 W South Jordan Pkwy
Ste 200
South Jordan, UT 84095
Phone (801) 561-8088

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1669662425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 W SOUTH JORDAN PKWY",
            "address_2": "SUITE 200",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954652",
            "telephone_number": "801-561-8088",
            "fax_number": "801-562-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 W SOUTH JORDAN PKWY",
            "address_2": "SUITE 200",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954652",
            "telephone_number": "801-561-8088",
            "fax_number": "801-562-8286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE S CHRISTENSEN, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-561-8088",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wasatch Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.