Daniel Shawn Funk, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9762495-9922 Issued in UT

Practice address

1345 E 3900 S
Suite 108
Salt Lake City, UT 84124-1474

Phone

(801) 274-3768

Fax

(801) 273-9768

NPI assigned

Jun 15, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Daniel M Cohen DMD PC

  • Dental Clinic/Center
  • Salt Lake City, UT
  • NPI 1134709488
  NPD (past)

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1669822177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 E 3900 S",
            "address_2": "SUITE 108",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241474",
            "telephone_number": "801-274-3768",
            "fax_number": "801-273-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 E 3900 S",
            "address_2": "SUITE 108",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241474",
            "telephone_number": "801-274-3768",
            "fax_number": "801-273-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "DANIEL",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "9762495-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel W. Fults III, MD
• Amanda Christine Hess Funaki
• Functionally Integrative Therapy LLC
• Camille Manyan Fung, MD
• Christopher Funk, DPM
• Deborah Gay Funk
• Derek Christopher Funk, D.D.S.
• K. Christopher Funk Jr., DMD
• Sydnee Funk
• Taylor Funk

• All providers in Salt Lake City, UT
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.