McKay B Packer, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6221162-9922 Issued in UT

Practice address

1275 Fort Union Blvd Ste 210
Midvale, UT 84047-1885

Phone

(801) 566-5959

Fax

(801) 304-9322

NPI assigned

May 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699984526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 FORT UNION BLVD STE 210",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471885",
            "telephone_number": "801-566-5959",
            "fax_number": "801-304-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 FORT UNION BLVD STE 210",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471885",
            "telephone_number": "801-566-5959",
            "fax_number": "801-304-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKER",
        "first_name": "MCKAY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6221162-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer D Osorio
• Katherine Ovrom
• Christian Ownsbey, MAC
• Ashla Pace
• Barlow L. Packer, D.D.S.
• Pain Management Pi (Car Injury Clinic, LLC)
• Julia Marie Palmieri, FNP-C, APRN
• Cesar A. Paredes, DMD
• Gerald Parrott, SUDC
• Alisa Kay Parry, CSW

• General Practice Dentistry in Midvale, UT
• Providers in Midvale, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.