NPIMap

Organization Active NPI

Packard Dental PC

  • General Practice Dentistry
  • Roy, UT
National Provider Identifier
1831421155
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2948359922 Issued in UT
Legal business name
PACKARD DENTAL PC
Practice address
3505 W 4800 S
Roy, UT 84067-9461
Phone
(801) 985-3300
Fax
(801) 985-3301
NPI assigned
Feb 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Authorized official

Name
Jonathan D Packard, D.M.DNPI 1457373805
Title
Dentist
Phone
(801) 985-3300

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 2948359922 UT Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 72615429921 UT

Addresses

Primary practice location

3505 W 4800 S
Roy, UT 84067-9461

Mailing address

3505 W 4800 S
Roy, UT 84067
Phone (801) 985-3300

National Provider Directory

National Provider Directory

Locations

3505 W 4800 S
Roy, UT 84067
Phone (801) 985-3300

Practitioners & affiliated clinicians

Practitioners 4

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": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1831421155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 W 4800 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "84067",
            "telephone_number": "801-985-3300",
            "fax_number": "801-985-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 W 4800 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679461",
            "telephone_number": "801-985-3300",
            "fax_number": "801-985-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACKARD DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "PACKARD",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "801-985-3300",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "2948359922",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "72615429921",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.