Active NPI
Eric Lee Palmer, DDS
- General Practice Dentistry
- Tooele, UT
National Provider Identifier
1841780780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11385204
- Practice address
- 271 S Main St
Tooele, UT 84074-2743 - Phone
- (435) 882-3700
- NPI assigned
- May 16, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11385204 | UT | Primary |
Addresses
Primary practice location
271 S Main St
Tooele, UT 84074-2743
Mailing address
MSC (06-3500) 1 University of New Mexico
Albuquerque, NM 87131-0001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180807001575 | NM | Order and Referring Only - Dentist | 4981952017 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11385204 | UT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676937600000",
"number": "1841780780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MSC (06-3500) 1 UNIVERSITY OF NEW MEXICO",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871310001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "271 S MAIN ST",
"city": "TOOELE",
"state": "UT",
"postal_code": "840742743",
"telephone_number": "435-882-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "ERIC",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-16",
"last_updated": "2023-02-21",
"certification_date": "2023-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "11385204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tooele, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.