Rose Park Pediatric Dentistry, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

49534949923 Issued in UT

Legal business name

ROSE PARK PEDIATRIC DENTISTRY, PC

Practice address

55 N Redwood Rd Ste B
Salt Lake City, UT 84116-3174

Phone

(801) 519-2222

NPI assigned

Feb 18, 2009

Last updated

Feb 18, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

49534949923As reported in NPPES

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

Authorized official

Name

Dr. Richard Ryan Johansen, DDS

Title

Owner

Phone

(801) 519-2222

Specialties & licenses 1

Addresses

Part of

Jordan Landing Pediatrics

Locations

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.

• Treagan Nephi White, DDS

  • Pediatric Dentistry
  • Salt Lake City, UT
  • NPI 1659667343
  NPD (past)

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1831338623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 N REDWOOD RD STE B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841163174",
            "telephone_number": "801-519-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N REDWOOD RD STE B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841163174",
            "telephone_number": "801-519-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE PARK PEDIATRIC DENTISTRY, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "49534949923",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-519-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "49534949923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Maria Rosas Herrera, MD
• Henry Rosas
• Josselyn Rosas
• Mary Rosbach, PA-C
• Allyson Roscher
• Alexandra Rose, MD
• Barry Rose
• Jennifer Rose, DDS
• John W. Rose, M.D.
• Justin Rose

• Pediatric Dentistry in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.