Active NPI
Nathan Daniel Stevenson, D.D.S.
- Pediatric Dentistry
- Riverton, UT
National Provider Identifier
1942376231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5863508-9923
- Practice address
- 4019 W 12600 S
Suite 200
Riverton, UT 84096 - Phone
- (801) 302-7938
- Fax
- (801) 302-9409
- NPI assigned
- Nov 28, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5863508-9923 | UT | Primary |
Addresses
Primary practice location
4019 W 12600 S
Suite 200
Riverton, UT 84096
Mailing address
14524 S Friendship Dr
Herriman, UT 84096-3470
Phone (801) 446-9965
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5863508-9923 | UT | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445904000000",
"number": "1942376231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14524 S FRIENDSHIP DR",
"city": "HERRIMAN",
"state": "UT",
"postal_code": "840963470",
"telephone_number": "801-446-9965",
"fax_number": "801-302-9409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4019 W 12600 S",
"address_2": "SUITE 200",
"city": "RIVERTON",
"state": "UT",
"postal_code": "84096",
"telephone_number": "801-302-7938",
"fax_number": "801-302-9409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "NATHAN",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2015-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "UT",
"license": "5863508-9923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.