Out of This World Dentistry SJ PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

OUT OF THIS WORLD DENTISTRY SJ PC

Doing business as

Out of This World SJ

Practice address

10426 S. 4000 W.
South Jordan, UT 84009

Phone

(801) 260-0400

Fax

(801) 619-5399

NPI assigned

Aug 21, 2014

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

OUT OF THIS WORLD DENTISTRY PCAs reported in NPPES

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

Authorized official

Name

Cory Stark, DDS

Title

Owner

Phone

(801) 260-0400

Specialties & licenses 1

Addresses

Other names 1

• Out of This World SJ Doing business as

Part of

Out of This World Dentistry PC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Out of This World Dentistry PC

  dba Out of This World Dentistry

  • Pediatric Dentistry
  • Draper, UT
  • NPI 1558760959
  NPPES parent name

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1811396260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10426 S. 4000 W.",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84009",
            "telephone_number": "801-260-0400",
            "fax_number": "801-619-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10426 S. 4000 W.",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84009",
            "telephone_number": "801-260-0400",
            "fax_number": "801-619-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUT OF THIS WORLD DENTISTRY SJ PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUT OF THIS WORLD DENTISTRY PC",
        "enumeration_date": "2014-08-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-260-0400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Out of This World SJ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peter G Osborn, MS, MA
• Jayde Ostler
• Dave Ottesen, CMHC
• Yun Jou Ou Yang, PHARMD
• Our House of South Jordan (River Pointe Management)
• Barbara Joelle Overby, DMSC, PA-C
• Patience Owan
• David Gareth Owen, MD
• McKinsey Owen, FNP-C
• Own My Health LLC (Own My Health)

• Pediatric Dentistry in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.