Jonathan Ray Elmer, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DEN.00202469 Issued in CO

Practice address

55 E. 2200 S.
Bountiful, UT 84010

Phone

(801) 295-5115

Fax

(801) 294-0829

NPI assigned

Aug 15, 2006

Last updated

Feb 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Legacy Family Dental of Bountiful LLC

  • Health Maintenance Organization
  • Bountiful, UT
  • NPI 1275859589
  NPD (past)
• Blackrock Dental Partners, PLLC

  dba Blackrock Dental

  • Dentist
  • Pocatello, ID
  • NPI 1356643308
  NPD (past)
• Johnson & Snow Dental, PA

  • Dentist
  • Pocatello, ID
  • NPI 1881810281
  NPD (past)
• Powers Dental Group, LLP

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1235216052
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1730192980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5780 N CAREFREE CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809172795",
            "telephone_number": "719-597-9737",
            "fax_number": "719-597-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E. 2200 S.",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "84010",
            "telephone_number": "801-295-5115",
            "fax_number": "801-294-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMER",
        "first_name": "JONATHAN",
        "middle_name": "RAY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00202469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luann Elliott
• G Richard Ellis, PA-C
• Tammy Ellis
• Tracy Ellis, PSYD
• Christina Ellwanger, LCSW
• Eln Enterprises
• Hailey Embley
• Embrace Clinical Services and Consulting
• Emergency Physicians Integrated Care
• Ryan Bruce Empey, M.D.

• Dentist in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.