Salt Lake Donated Dental Services

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SALT LAKE DONATED DENTAL SERVICES

Practice address

1383 S 900 W
Suite 128
Salt Lake City, UT 84104-1603

Phone

(801) 983-0350

Fax

(801) 983-0353

NPI assigned

Jan 13, 2009

Last updated

Jan 16, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Stephanie M. Jensen

Title

Executive Director

Phone

(801) 983-0351

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SLDDS Other name

Locations

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1851538862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1383 S 900 W",
            "address_2": "SUITE 128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841041603",
            "telephone_number": "801-983-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1383 S 900 W",
            "address_2": "SUITE 128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841041603",
            "telephone_number": "801-983-0350",
            "fax_number": "801-983-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE DONATED DENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-13",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-983-0351",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870422710002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SLDDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Salt Lake County Division of Youth Services
• Salt Lake County Jail
• Salt Lake County Youth Services
• Salt Lake Dental Care
• Salt Lake Dermatology and Aesthetics PC
• Salt Lake Endodontics
• Salt Lake Endoscopy Center
• Salt Lake Eye Associates, LLC
• Salt Lake Family Health CNTR
• Salt Lake Foot and Ankle PLLC

• Dental Clinic/Center in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.