Park City Dental Spa

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PARK CITY DENTAL SPA

Practice address

1526 Ute Blvd Ste 212
Park City, UT 84098-7654

Phone

(435) 615-8500

Fax

(435) 214-7246

NPI assigned

Oct 12, 2021

Organization subpart

No

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

Authorized official

Name

Dawnetta Kay Abraham, RDH

Title

Manager

Phone

(435) 615-8500

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Danielle M Demeter, CNM

  • Family Nurse Practitioner
  • Park City, UT
  • NPI 1265447940
  NPD
• David Sandberg, D.D.S.

  • Dentist
  • Park City, UT
  • NPI 1780945667
  NPD
• Ashley G. Bailey, D.D.S.

  • Dentist
  • Salt Lake City, UT
  • NPI 1043478217
  NPD (past)

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1760144117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 UTE BLVD STE 212",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840987654",
            "telephone_number": "435-615-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 UTE BLVD STE 212",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840987654",
            "telephone_number": "435-615-8500",
            "fax_number": "435-214-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK CITY DENTAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "DAWNETTA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "435-615-8500",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Jean Page, APRN
• Kathleen M Papi-Baker, OT
• Park City Chiropractic L.C.
• Park City Clinic Pharmacy
• Park City Dental Associates LLC
• Park City Dermatology. Co
• Park City Endodontics LLC
• Park City Fire Service District
• Park City Gynecology, LLC
• Park City Healthcare, PC

• Dental Clinic/Center in Park City, UT
• Providers in Park City, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.