NPIMap

Organization Active NPI

Kidz Dental Works

  • Dentist
  • Syracuse, UT
National Provider Identifier
1730224643
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
266402 Issued in UT
Legal business name
KIDZ DENTAL WORKS
Practice address
780 S 2000 W
BLDG F2
Syracuse, UT 84075
Phone
(801) 776-8176
Fax
(801) 774-9085
NPI assigned
Feb 20, 2007
Last updated
Jul 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Authorized official

Name
Dr. Gary Scott Wall, DDSNPI 1760850523
Title
Owner
Phone
(801) 776-8176

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 266402 UT Primary

Addresses

Primary practice location

780 S 2000 W
BLDG F2
Syracuse, UT 84075

Mailing address

780 S 2000 W
BLDG F2
Syracuse, UT 84075
Phone (801) 776-8176

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1730224643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 S 2000 W",
            "address_2": "BLDG F2",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "84075",
            "telephone_number": "801-776-8176",
            "fax_number": "801-774-9085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 S 2000 W",
            "address_2": "BLDG F2",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "84075",
            "telephone_number": "801-776-8176",
            "fax_number": "801-774-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ DENTAL WORKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-776-8176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "266402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.