NPIMap

Individual provider Active NPI

Daniel Jay Theurer, D.D.S.

  • Dentist
  • Salt Lake City, UT
National Provider Identifier
1699904540
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7394687 Issued in UT
Practice address
1955 S 1300 E
Suite L-2
Salt Lake City, UT 84105-3658
Phone
(801) 486-9649
Fax
(801) 486-9640
NPI assigned
Jul 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7394687 UT Primary

Addresses

Primary practice location

1955 S 1300 E
Suite L-2
Salt Lake City, UT 84105-3658

Mailing address

1955 S 1300 E
Suite L-2
Salt Lake City, UT 84105-3658
Phone (801) 486-9649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7394687UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sugar House Dental Management LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247443200000",
    "number": "1699904540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 S 1300 E",
            "address_2": "SUITE L-2",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053658",
            "telephone_number": "801-486-9649",
            "fax_number": "801-486-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 S 1300 E",
            "address_2": "SUITE L-2",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053658",
            "telephone_number": "801-486-9649",
            "fax_number": "801-486-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEURER",
        "first_name": "DANIEL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "7394687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.