Intermountain Dental Specialists

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

8041458 Issued in UT

Legal business name

INTERMOUNTAIN DENTAL SPECIALISTS

Practice address

2797 N Highway 89
Suite 200
Pleasant View, UT 84404-1216

Phone

(801) 782-5682

Fax

(801) 786-0520

NPI assigned

Dec 11, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Vicki Lewis

Title

Specialist Coordinator

Phone

(801) 782-5682

Specialties & licenses 6

Addresses

Tax ID family

Intermountain Dental Specialists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Intermountain Dental Specialists, LLC

  • Endodontics
  • Syracuse, UT
  • NPI 1780048868
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brady N Maxfield, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pleasant View, UT
  • NPI 1548513708
  NPD (past)

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1881069177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2797 N HIGHWAY 89",
            "address_2": "SUITE 200",
            "city": "PLEASANT VIEW",
            "state": "UT",
            "postal_code": "844041216",
            "telephone_number": "801-782-5682",
            "fax_number": "801-786-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2797 N HIGHWAY 89",
            "address_2": "SUITE 200",
            "city": "PLEASANT VIEW",
            "state": "UT",
            "postal_code": "844041216",
            "telephone_number": "801-782-5682",
            "fax_number": "801-786-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN DENTAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "SPECIALIST COORDINATOR",
        "authorized_official_telephone_number": "801-782-5682",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "145326-9922",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "145288-9922",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "UT",
            "license": "137712-9922",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "8598613-9924",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "9371431-9921",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "8041458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher J Harris, PA-C
• Haven Dental LLC
• Lamont E Hesselgesser, D.D.S.
• Hospice Care of Northern Utah, LLC
• I & T Whipple PLLC
• Kelsey Johnson, PA-C
• Marc Alan Jolley, DDS
• Makinzee Rae Kemp, PA-C
• Dirk Murdock Lighthall, D.D.S.
• Lomond View Dental

• Orthodontics and Dentofacial Orthopedics Dentistry in Pleasant View, UT
• Providers in Pleasant View, UT by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.