Organization Active NPI

Lakeview Dental Coorperation

  • Dentist
  • Roy, UT
National Provider Identifier
1710188933
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5370773990001 Issued in OR
Legal business name
LAKEVIEW DENTAL COORPERATION
Practice address
3626 W 5600 S
Roy, UT 84067-9161
Phone
(801) 985-2273
Fax
(801) 459-8781
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James V Anderson, D.M.D.
Title
Owner
Phone
(801) 985-2273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5370773990001 OR Primary

Addresses

Primary practice location

3626 W 5600 S
Roy, UT 84067-9161

Mailing address

3626 W 5600 S
Roy, UT 84067-9161
Phone (801) 985-2273

National Provider Directory

National Provider Directory

Locations

3626 W 5600 S
Roy, UT 84067
Phone (801) 985-2273

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710188933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 W 5600 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679161",
            "telephone_number": "801-985-2273",
            "fax_number": "801-459-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 W 5600 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679161",
            "telephone_number": "801-985-2273",
            "fax_number": "801-459-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW DENTAL COORPERATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-985-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "5370773990001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.