Individual provider Active NPI

Edward James Sittler, D.D.S.

  • Dentist
  • Draper, UT
National Provider Identifier
1790796258
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59894059921 Issued in UT
Practice address
14717 Minuteman Dr.
Utah Department of Corrections-Clinical Services
Draper, UT 84020
Phone
(801) 576-7107
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 59894059921 UT Primary

Addresses

Primary practice location

14717 Minuteman Dr.
Utah Department of Corrections-Clinical Services
Draper, UT 84020

Mailing address

2711 Deer Meadow Dr
Lehi, UT 84043-5554
Phone (801) 602-6941

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

LicenseStateTypeSpecialty
59894059921UTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790796258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 DEER MEADOW DR",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840435554",
            "telephone_number": "801-602-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14717 MINUTEMAN DR.",
            "address_2": "UTAH DEPARTMENT OF CORRECTIONS-CLINICAL SERVICES",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "84020",
            "telephone_number": "801-576-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITTLER",
        "first_name": "EDWARD",
        "middle_name": "JAMES",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "59894059921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.