Eagle Mountain Children's Dentistry PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

EAGLE MOUNTAIN CHILDREN'S DENTISTRY PLLC

Practice address

3435 Pony Express Parkway Ste. 130
Eagle Mountain, UT 84005

Phone

(801) 562-2222

NPI assigned

Oct 8, 2018

Last updated

Oct 8, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Erik Rooklidge, DDSNPI 1669517751

Title

President

Phone

(801) 674-7702

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Erik Richard Rooklidge, D.D.S.

  • Pediatric Dentistry
  • Sandy, UT
  • NPI 1669517751
  NPD (past) Authorized official

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538956800000",
    "number": "1922573856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10011 S CENTENNIAL PKWY STE 250",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704121",
            "telephone_number": "801-562-2222",
            "fax_number": "801-562-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 PONY EXPRESS PARKWAY STE. 130",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "84005",
            "telephone_number": "801-562-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MOUNTAIN CHILDREN'S DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A",
        "authorized_official_last_name": "ROOKLIDGE",
        "authorized_official_first_name": "ERIK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-674-7702",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529313580002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcia De Oliveira Silva Alves
• Meagan Dexter, L.M.T
• Dawn Victoria Dick, LMT, NMT, FS, CHHC
• Kari Done
• Paula Duke, LMT
• Eagle Mountain City (Eagle Mountain City Ambulance)
• Eagle Mountain Midwife LLC
• Eagle Vision
• Kelsey Eastman
• Valerie J Elhalta

• Dental Clinic/Center in Eagle Mountain, UT
• Providers in Eagle Mountain, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.