Active NPI
Matthew Robert Palmer, DDS
- Pediatric Dentistry
- Layton, UT
National Provider Identifier
1871158329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 13150075
- Practice address
- 1597 Woodland Park Dr Ste 200
Layton, UT 84041-5696 - Phone
- (801) 544-1940
- Fax
- (801) 896-0645
- NPI assigned
- May 9, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30.026249 | OH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | TD-00-112 | NM | |
| Pediatric Dentistry | 1223P0221X | 13150075 | UT | Primary |
Addresses
Primary practice location
1597 Woodland Park Dr Ste 200
Layton, UT 84041-5696
Mailing address
1597 Woodland Park Dr Ste 200
Layton, UT 84041-5696
Phone (801) 544-1940
Other practice location 1
Msc (Department) 1 University Of New Mexico Albuquerque
Albuquerque, NM 87131-0001
Phone (505) 925-4031
Other practice location 2
2300 W Broad St Fl 2
Columbus, OH 43204-3783
Phone (614) 645-2300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.026249 | OH | MD | General Practice Dentistry |
| 13150075 | UT | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1871158329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1597 WOODLAND PARK DR STE 200",
"city": "LAYTON",
"state": "UT",
"postal_code": "840415696",
"telephone_number": "801-544-1940",
"fax_number": "801-896-0645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1597 WOODLAND PARK DR STE 200",
"city": "LAYTON",
"state": "UT",
"postal_code": "840415696",
"telephone_number": "801-544-1940",
"fax_number": "801-896-0645"
}
],
"practiceLocations": [
{
"address_1": "Msc (Department) 1 University Of New Mexico Albuquerque",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871310001",
"country_code": "US",
"telephone_number": "505-925-4031",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2300 W Broad St Fl 2",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432043783",
"country_code": "US",
"telephone_number": "614-645-2300",
"fax_number": "614-645-2333",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PALMER",
"first_name": "MATTHEW",
"middle_name": "ROBERT",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-09",
"last_updated": "2023-08-16",
"certification_date": "2023-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30.026249",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": "TD-00-112",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "UT",
"license": "13150075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.