Justin Jay Nybo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10387202-9922 Issued in UT

Practice address

525 N Fairfield Rd
Layton, UT 84041-3339

Phone

(801) 444-9911

Fax

(801) 544-2255

NPI assigned

Jun 9, 2017

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gardner Dental

  • General Practice Dentistry
  • Layton, UT
  • NPI 1124554811
  NPD (past)

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1841729027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N FAIRFIELD RD",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840413339",
            "telephone_number": "801-444-9911",
            "fax_number": "801-544-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N FAIRFIELD RD",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840413339",
            "telephone_number": "801-444-9911",
            "fax_number": "801-544-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYBO",
        "first_name": "JUSTIN",
        "middle_name": "JAY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "10387202-9922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "10387202-9922",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northstar Behavioral Health LLC
• Kaytlee Nowell
• Lauren Nuttall
• Anastel Nuusila
• Aubrey Nyberg
• Brandt Nye, CMHC
• Noel C Nye, DO
• O & M Home Care, Inc. (Visiting Angles of Davis/Weber)
• Cambria O'Neal
• Dylan O'Neal

• General Practice Dentistry in Layton, UT
• Providers in Layton, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.