Jon Ralph Chisholm, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

973419729921 Issued in UT

Practice address

10 S 300 W
Santaquin, UT 84655-8147

Phone

(801) 754-0678

Fax

(801) 754-1157

NPI assigned

Dec 1, 2006

Last updated

Aug 3, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jon Chisholm Dentistry

  • General Practice Dentistry
  • Santaquin, UT
  • NPI 1548575954
  NPD (past) Authorized official

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1811065683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S 300 W",
            "address_2": "P.O BOX 266",
            "city": "SANTAQUIN",
            "state": "UT",
            "postal_code": "846558147",
            "telephone_number": "801-754-0678",
            "fax_number": "801-754-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S 300 W",
            "city": "SANTAQUIN",
            "state": "UT",
            "postal_code": "846558147",
            "telephone_number": "801-754-0678",
            "fax_number": "801-754-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "JON",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "973419729921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Binks, CMHC
• Wesley S Bott, DO
• Irina M. Campbell
• Canyon View Medical Group (Santaquin Medical Center)
• Canyon View Medical Group LLC (Santaquin Medical C linic)
• Joshua Richard Chisholm, DMD
• Nathan Richard Christensen, O.D.
• Jessica Clegg
• Tonya Coates, NP-C
• Copper Heights Wellness PLLC (South Valley Psychiatry & Wellness)

• General Practice Dentistry in Santaquin, UT
• Providers in Santaquin, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.