NPIMap

Organization Active NPI

Center Square Family Dental, PLLC

  • General Practice Dentistry
  • Midvale, UT
National Provider Identifier
1669842647
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5329882 Issued in UT
Legal business name
CENTER SQUARE FAMILY DENTAL, PLLC
Practice address
7679 S Center SQ
Midvale, UT 84047-7329
Phone
(801) 255-4821
Fax
(801) 566-8143
NPI assigned
Oct 2, 2015
Last updated
Oct 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Authorized official

Name
James Alcorn, DMD
Title
Manager/Dentist
Phone
(801) 255-4821

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5329882 UT Primary

Addresses

Primary practice location

7679 S Center SQ
Midvale, UT 84047-7329

Mailing address

7679 S Center SQ
Midvale, UT 84047-7329
Phone (801) 255-4821

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1443744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1669842647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7679 S CENTER SQ",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840477329",
            "telephone_number": "801-255-4821",
            "fax_number": "801-566-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7679 S CENTER SQ",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840477329",
            "telephone_number": "801-255-4821",
            "fax_number": "801-566-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER SQUARE FAMILY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-02",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "ALCORN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGER/DENTIST",
        "authorized_official_telephone_number": "801-255-4821",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5329882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.