Smart Smiles Utah

Primary specialty

DentistTaxonomy code 122300000X

License

9860439-9921 Issued in UT

Legal business name

SMART SMILES UTAH

Practice address

10597 S Beach Comber Way
South Jordan, UT 84009-6132

Phone

(801) 649-4222

NPI assigned

Aug 31, 2018

Organization subpart

No

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

Authorized official

Name

Tanner M Clark, DMD

Title

Manager

Phone

(801) 649-4222

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535673600000",
    "number": "1679055081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10597 S BEACH COMBER WAY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840096132",
            "telephone_number": "801-649-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10597 S BEACH COMBER WAY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840096132",
            "telephone_number": "801-649-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMART SMILES UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TANNER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-649-4222",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "9860439-9921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9860439-9921",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sleep Synergies, LLC
• Sleepwell Partner LLC
• Slickrock Ventures, LLC (FirstLight Home Care of South Jordan)
• Slmri, LLC
• Keagan Tice Smallwood, DC
• Ashley Smith
• Brigham Ronald Smith, M.D.
• Courtney Cusick Smith
• Emily Ann Smith, ACMHC
• Evan Smith

• Dentist in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.