NPIMap

Organization Active NPI

Millcreek Family Dental PC

  • Dentist
  • Bountiful, UT
National Provider Identifier
1871668996
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MILLCREEK FAMILY DENTAL PC
Practice address
1455 S 500 W Suite D
Bountiful, UT 84010-8264
Phone
(801) 292-4009
Fax
(801) 292-3278
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Anthony J Baird, DDSNPI 1093898561
Title
Owner
Phone
(801) 292-4009

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1455 S 500 W Suite D
Bountiful, UT 84010-8264

Mailing address

1455 S 500 W Suite D
Bountiful, UT 84010-8264
Phone (801) 292-4009

National Provider Directory

National Provider Directory

Locations

1455 S 500 W
Ste D
Bountiful, UT 84010
Phone (801) 292-4009

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871668996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 S 500 W SUITE D",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108264",
            "telephone_number": "801-292-4009",
            "fax_number": "801-292-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 S 500 W SUITE D",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108264",
            "telephone_number": "801-292-4009",
            "fax_number": "801-292-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLCREEK FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAIRD",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-292-4009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.