NPIMap

Organization Active NPI

Swan Pediatric Dental

  • General Practice Dentistry
  • Salem, UT
National Provider Identifier
1841763513
Registry record updated Jan 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SWAN PEDIATRIC DENTAL
Doing business as
Salem Smiles
Practice address
601 N State Road 198
Salem, UT 84653-4504
Phone
(801) 423-7969
NPI assigned
Jan 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2019

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

Authorized official

Name
Dr. Matthew Allen Swan, DDSNPI 1336405315
Title
Owner
Phone
(801) 718-8348

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

601 N State Road 198
Salem, UT 84653-4504

Mailing address

1177 W 1960 N
Pleasant Grove, UT 84062-4039
Phone (801) 718-8348

Other practice location 1

54 N Main St
Nephi, UT 84648-1402
Phone (435) 580-5055

Other identifiers 1

IdentifierTypeStateIssuer
1336405315MedicaidUT

Other names 1

  • Salem Smiles Doing business as

National Provider Directory

National Provider Directory

Locations

81 W 500 S
Bountiful, UT 84010
Phone (801) 335-5629

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1546732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546732800000",
    "number": "1841763513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 W 1960 N",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840624039",
            "telephone_number": "801-718-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N STATE ROAD 198",
            "city": "SALEM",
            "state": "UT",
            "postal_code": "846534504",
            "telephone_number": "801-423-7969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54 N Main St",
            "address_purpose": "LOCATION",
            "city": "Nephi",
            "state": "UT",
            "postal_code": "846481402",
            "country_code": "US",
            "telephone_number": "435-580-5055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SWAN PEDIATRIC DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-06",
        "last_updated": "2019-01-06",
        "status": "A",
        "authorized_official_last_name": "SWAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-718-8348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336405315",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salem Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2019; 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.