Active NPI
Donald Ray Gifford, DDS
- Pediatric Dentistry
- Provo, UT
National Provider Identifier
1821093048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 29022
- Practice address
- 2230 N University Pkwy
8-B
Provo, UT 84604-1509 - Phone
- (801) 377-6400
- Fax
- (801) 377-6450
- NPI assigned
- Jun 15, 2005
- Last updated
- Sep 24, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 2560 | UT | |
| Pediatric Dentistry | 1223P0221X | 29022 | TX | Primary |
Addresses
Primary practice location
2230 N University Pkwy
8-B
Provo, UT 84604-1509
Mailing address
2230 N University Pkwy
8-B
Provo, UT 84604-1509
Phone (801) 377-6400
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
| License | State | Type | Specialty |
|---|---|---|---|
| 29022 | TX | MD | Pediatric Dentist |
| 2560 | UT | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1821093048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2230 N UNIVERSITY PKWY",
"address_2": "8-B",
"city": "PROVO",
"state": "UT",
"postal_code": "846041509",
"telephone_number": "801-377-6400",
"fax_number": "801-377-6450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2230 N UNIVERSITY PKWY",
"address_2": "8-B",
"city": "PROVO",
"state": "UT",
"postal_code": "846041509",
"telephone_number": "801-377-6400",
"fax_number": "801-377-6450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIFFORD",
"first_name": "DONALD",
"middle_name": "RAY",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-15",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "UT",
"license": "2560",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "29022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.