Genesis Dental of Salt Lake, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GENESIS DENTAL OF SALT LAKE, LLC

Practice address

420 E South Temple Ste 220
Salt Lake City, UT 84111-1329

Phone

(801) 355-3286

Fax

(801) 355-1320

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jason D Casto

Title

Owner/Member

Phone

(801) 870-0625

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Michael Visser, DMD

  • Dentist
  • Salt Lake City, UT
  • NPI 1053627844
  NPD (past)
• Timothy S Heward, D.D.S

  • General Practice Dentistry
  • Montrose, CO
  • NPI 1427252386
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1710095781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12180 S 300 E UNIT 270",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840202612",
            "telephone_number": "801-870-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E SOUTH TEMPLE STE 220",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841111329",
            "telephone_number": "801-355-3286",
            "fax_number": "801-355-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS DENTAL OF SALT LAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "CASTO",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "801-870-0625",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lois Jeanne Gemmell, MD
• Maricar N. Gener, DO
• Generalhealthgroup of Utah (Utah Eye Associates)
• Generations Chiropractic
• Genesis Chiropractic, Inc.
• Genesis Services, Inc.
• Genesis Vascular of Salt Lake (Genesis Vascular of Salt Lake, LLC)
• Renee Marie Gengelbach
• Amy Marie Genisot, PHARMD
• Vanessa Genova

• General Practice Dentistry in Salt Lake City, UT
• Providers in Salt Lake City, 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 Mar 26, 2024; 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.