Dan Hibbert Urology, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

7100427-1205 Issued in UT

Legal business name

DAN HIBBERT UROLOGY, LLC

Practice address

4052 Pioneer Pkwy
#202
Salt Lake City, UT 84120-2062

Phone

(801) 955-4685

NPI assigned

Jan 23, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Dan Hibbert, MD

Title

Manager

Phone

(801) 822-2727

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285545600000",
    "number": "1942448329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11179 IVY CREEK CV",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840952249",
            "telephone_number": "801-822-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4052 PIONEER PKWY",
            "address_2": "#202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841202062",
            "telephone_number": "801-955-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAN HIBBERT UROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-23",
        "last_updated": "2010-09-27",
        "status": "A",
        "authorized_official_last_name": "HIBBERT",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-822-2727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QL0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Lithotripsy",
            "state": "UT",
            "license": "7100427-1205",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "UT",
            "license": "7100427-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodie Vallyn Damiano
• Nikolas Michael Damme, MD
• Alysha Damron
• Gregory Freeman Damron
• Naomi Damron
• Cassie Dance, PH.D.
• Logan Richard Dance, M.D.
• Melanie Ann Dance, M.D.
• Timothy Robert Dance, MD
• Janeaise Lynn Dancy

• Medical Specialty Clinic/Center in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Medical Specialty Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.