Creek Capital Orchard Drive LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CREEK CAPITAL ORCHARD DRIVE LLC

Practice address

3377 Orchard Dr
Bountiful, UT 84010-8005

Phone

(801) 951-8038

NPI assigned

Aug 30, 2017

Organization subpart

No

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

Authorized official

Name

Marci Nicol

Title

Coo

Phone

(801) 312-7122

Specialties & licenses 1

Addresses

Other names 1

• Burg Children's Dentistry & Orthodontics-Orchard Drive Doing business as

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504051200000",
    "number": "1770001612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 E VINE ST STE 10",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075500",
            "telephone_number": "801-918-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3377 ORCHARD DR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108005",
            "telephone_number": "801-951-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEK CAPITAL ORCHARD DRIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-08-30",
        "status": "A",
        "authorized_official_last_name": "NICOL",
        "authorized_official_first_name": "MARCI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "801-312-7122"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burg Children's Dentistry & Orthodontics-Orchard Drive",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Crafton
• Rachel Gabrielle Crandall, PT, DPT
• Kelsey Crapo, FNP-C
• Abigail S Crawford
• Megan R Crawford, DPT
• Suzanna Cressall, CSW
• Sarah E Croskell, MD
• Angela Crow
• Luis Felipe Cruz Cala
• Joe Campbell Culbertson, M.D.

• Pediatric Dentistry in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2017; 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.