NPIMap

Organization Active NPI

Salt Lake Modern Dentistry, LLP

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1730647330
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SALT LAKE MODERN DENTISTRY, LLP
Practice address
1028 E 2100 S Ste 3
Salt Lake City, UT 84106-3096
Phone
(801) 438-6355
Fax
(801) 386-5639
NPI assigned
Mar 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Authorized official

Name
Adam Burr
Title
Owner
Phone
(801) 438-6355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1028 E 2100 S Ste 3
Salt Lake City, UT 84106-3096

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8500

National Provider Directory

National Provider Directory

Locations

1028 E 2100 S
Ste 3
Salt Lake City, UT 84106
Phone (801) 438-6355

Practitioners & affiliated clinicians

Practitioners 7

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": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551657600000",
    "number": "1730647330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 E 2100 S STE 3",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063096",
            "telephone_number": "801-438-6355",
            "fax_number": "801-386-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE MODERN DENTISTRY, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A",
        "authorized_official_last_name": "BURR",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-438-6355"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.