BKP Dental

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

5660293-9922 Issued in UT

Legal business name

BKP DENTAL

Practice address

4066 S 4000 W
Salt Lake City, UT 84120-4040

Phone

(801) 968-2864

NPI assigned

Oct 14, 2013

Organization subpart

No

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

Authorized official

Name

Phung Chau

Title

Owner Manager

Phone

(801) 541-6807

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381708800000",
    "number": "1730517517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4066 S 4000 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841204040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4066 S 4000 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841204040",
            "telephone_number": "801-968-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BKP DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-14",
        "last_updated": "2013-10-14",
        "status": "A",
        "authorized_official_last_name": "CHAU",
        "authorized_official_first_name": "PHUNG",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "801-541-6807"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "UT",
            "license": "5660293-9922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528832224001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Preferred Provider Organization in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; 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.