NPIMap

Organization Active NPI

Poole Orthodontics PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Logan, UT
National Provider Identifier
1720739451
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
POOLE ORTHODONTICS PC
Practice address
1340 N 600 E Ste 2
Logan, UT 84341-2475
Phone
(435) 753-0462
NPI assigned
Jan 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Authorized official

Name
Dr. Morris Poole, DDS
Title
President
Phone
(435) 753-0462

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

1340 N 600 E Ste 2
Logan, UT 84341-2475

Mailing address

1340 N 600 E Ste 2
Logan, UT 84341-2475
Phone (435) 753-0462

National Provider Directory

National Provider Directory

Locations

1340 N 600 E
Ste 2
Logan, UT 84341
Phone (435) 753-0462

Practitioners & affiliated clinicians

Practitioners 3

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": "1642118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1720739451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 N 600 E STE 2",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412475",
            "telephone_number": "435-753-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 N 600 E STE 2",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412475",
            "telephone_number": "435-753-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POOLE ORTHODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-753-0462",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.