NPIMap

Organization Active NPI

Intermountain Dental Specialists, LLC

  • Endodontics
  • Syracuse, UT
National Provider Identifier
1780048868
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
6413227-9922 Issued in UT
Legal business name
INTERMOUNTAIN DENTAL SPECIALISTS, LLC
Practice address
1747 Heritage LN
Syracuse, UT 84075-8552
Phone
(801) 841-3300
NPI assigned
Apr 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Authorized official

Name
Dr. Kevin Cahoon
Title
DDS
Phone
(801) 560-9757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 6413227-9922 UT Primary

Addresses

Primary practice location

1747 Heritage LN
Syracuse, UT 84075-8552

Mailing address

3150 Sawtelle Blvd Apt 308
Los Angeles, CA 90066-1445
Phone (707) 490-9125

National Provider Directory

National Provider Directory
Tax ID family
Intermountain Dental Specialists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1780048868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 SAWTELLE BLVD APT 308",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661445",
            "telephone_number": "707-490-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 HERITAGE LN",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840758552",
            "telephone_number": "801-841-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN DENTAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "CAHOON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "801-560-9757",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "6413227-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.

Verify at the official NPI Registry.