NPIMap

Organization Active NPI

Michael R. Cottam Ms DMD PLLC

  • Pediatric Dentistry
  • South Jordan, UT
National Provider Identifier
1679823058
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
8296939-9923 Issued in NU
Legal business name
MICHAEL R. COTTAM MS DMD PLLC
Practice address
4775 W Daybreak Pkwy
South Jordan, UT 84095-5968
Phone
(801) 261-3178
Fax
(801) 268-1930
NPI assigned
Sep 13, 2012
Last updated
Sep 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Authorized official

Name
Michael R Cottam, DMD
Title
Dentist
Phone
(801) 261-3178

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 8296939-9923 NU Primary

Addresses

Primary practice location

4775 W Daybreak Pkwy
South Jordan, UT 84095-5968

Mailing address

4775 W Daybreak Pkwy
South Jordan, UT 84095-5968
Phone (801) 261-3178

National Provider Directory

National Provider Directory

Locations

4775 W Daybreak Pkwy
South Jordan, UT 84009
Phone (801) 261-3178

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1679823058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 W DAYBREAK PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955968",
            "telephone_number": "801-261-3178",
            "fax_number": "801-268-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 W DAYBREAK PKWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955968",
            "telephone_number": "801-261-3178",
            "fax_number": "801-268-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R. COTTAM MS DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "COTTAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "801-261-3178",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": "8296939-9923",
            "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 Sep 13, 2012; 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.