Active NPI
Daren Fred Gehring, DDS
- Pediatric Dentistry
- Logan, UT
National Provider Identifier
1740341007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 2849469923
- Practice address
- 1624 N 200 E Ste 100
Logan, UT 84341-3141 - Phone
- (435) 752-4330
- Fax
- (435) 752-6330
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 2849469923 | UT | Primary |
Addresses
Primary practice location
1624 N 200 E Ste 100
Logan, UT 84341-3141
Mailing address
3297 N 1450 E
North Logan, UT 84341-6756
Phone (435) 753-3574
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119125000 | Medicaid | WY | |
| 806491800 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2849469923 | UT | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cache Valley Pediatric Dentistry | Current | Accepting new patients |
Locations
1624 N 200 E
Ste 100
Logan, UT 84341
Phone (435) 752-4330
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Logan, UT
- NPI 1962282459
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459987200000",
"number": "1740341007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3297 N 1450 E",
"city": "NORTH LOGAN",
"state": "UT",
"postal_code": "843416756",
"telephone_number": "435-753-3574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1624 N 200 E STE 100",
"city": "LOGAN",
"state": "UT",
"postal_code": "843413141",
"telephone_number": "435-752-4330",
"fax_number": "435-752-6330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEHRING",
"first_name": "DAREN",
"middle_name": "FRED",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2016-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "UT",
"license": "2849469923",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119125000",
"state": "WY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806491800",
"state": "ID"
}
],
"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 Apr 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.