Jared Garner Wolthuis, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4726790 Issued in UT

Practice address

512 12TH St
Ogden, UT 84404-5803

Phone

(801) 399-5832

Fax

(801) 399-5832

NPI assigned

Aug 15, 2007

Last updated

Dec 4, 2015By 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

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Canyon Dental Group LLC

  • General Practice Dentistry
  • Ogden, UT
  • NPI 1669887204
  NPD (past)

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1851583520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 12TH ST",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045803",
            "telephone_number": "801-399-5832",
            "fax_number": "801-399-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 12TH ST",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045803",
            "telephone_number": "801-399-5832",
            "fax_number": "801-399-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTHUIS",
        "first_name": "JARED",
        "middle_name": "GARNER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "4726790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krissy Wolf
• Matthew R. Wolpert, DMD
• Rachel Ilene Wolsey, LMT
• Bart Wilson Wolthuis, DDS
• Braden Wilson Wolthuis, ACNP
• John S Wolthuis, MD
• Jody B Wong, PT
• April Marie Wood
• Jennette May Wood, LCSW
• Jonathan Brady Wood

• Dentist in Ogden, UT
• Providers in Ogden, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; 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.

Verify at the official NPI Registry.