NPIMap

Organization Active NPI

Intermountain Dental Associates-Endodontics

  • Endodontics
  • North Ogden, UT
National Provider Identifier
1881962785
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
144024 Issued in UT
Legal business name
INTERMOUNTAIN DENTAL ASSOCIATES-ENDODONTICS
Practice address
2721 N 400 E
Suite 2
North Ogden, UT 84414-2393
Phone
(801) 782-5682
Fax
(801) 786-0520
NPI assigned
Dec 6, 2011
Last updated
Dec 6, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
INTERMOUNTAIN DENTAL ASSOCIATES SPECIALTY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Authorized official

Name
Vicki Lewis
Title
Specialist Coordintor
Phone
(801) 782-5682

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 144024 UT Primary

Addresses

Primary practice location

2721 N 400 E
Suite 2
North Ogden, UT 84414-2393

Mailing address

2721 N 400 E
Suite 2
North Ogden, UT 84414-2393
Phone (801) 782-5682

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1881962785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 N 400 E",
            "address_2": "SUITE 2",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844142393",
            "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": "2721 N 400 E",
            "address_2": "SUITE 2",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844142393",
            "telephone_number": "801-782-5682",
            "fax_number": "801-786-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN DENTAL ASSOCIATES-ENDODONTICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERMOUNTAIN DENTAL ASSOCIATES SPECIALTY LLC",
        "enumeration_date": "2011-12-06",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "SPECIALIST COORDINTOR",
        "authorized_official_telephone_number": "801-782-5682"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "144024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.