Organization Active NPI

Stephen D Haslam, DDS, PLLC

  • General Practice Dentistry
  • Murray, UT
National Provider Identifier
1821273673
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
143673-9923 Issued in UT
Legal business name
STEPHEN D HASLAM, DDS, PLLC
Practice address
6065 Fashion Blvd
Suite 275
Murray, UT 84107-7381
Phone
(801) 262-4628
Fax
(801) 262-9260
NPI assigned
Dec 28, 2007
Last updated
Dec 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Dr. Stephen Deaton Haslam, DDSNPI 1124147830
Title
Owner/Manager
Phone
(801) 262-4628

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 143673-9923 UT Primary

Addresses

Primary practice location

6065 Fashion Blvd
Suite 275
Murray, UT 84107-7381

Mailing address

6065 Fashion Blvd
Suite 275
Murray, UT 84107-7381
Phone (801) 262-4628

Other names 1

  • Stephen D Haslam, DDS Former legal business name

National Provider Directory

National Provider Directory

Locations

6065 S Fashion Blvd
Ste 275
Murray, UT 84107
Phone (801) 262-4628

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1821273673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6065 FASHION BLVD",
            "address_2": "SUITE 275",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077381",
            "telephone_number": "801-262-4628",
            "fax_number": "801-262-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6065 FASHION BLVD",
            "address_2": "SUITE 275",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077381",
            "telephone_number": "801-262-4628",
            "fax_number": "801-262-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN D HASLAM, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "HASLAM",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "DEATON",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "801-262-4628",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "143673-9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stephen D Haslam, DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.