Amigos Dental Care- Meadowbrook, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

AMIGOS DENTAL CARE- MEADOWBROOK, LLC

Doing business as

Creek Dental Group at Meadowbrook

Practice address

4085 S 2200 W Ste B
West Valley City, UT 84119-6576

Phone

(801) 618-1013

NPI assigned

Jun 17, 2021

Last updated

Jun 17, 2021By 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

Benjamin Bowman, DDS

Title

Owner/Partner

Phone

(405) 326-8004

Specialties & licenses 1

Addresses

Other names 1

• Creek Dental Group at Meadowbrook Doing business as

Locations

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1942879622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 S 2200 W STE B",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841196576",
            "telephone_number": "801-618-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 S 2200 W STE B",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841196576",
            "telephone_number": "801-618-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMIGOS DENTAL CARE- MEADOWBROOK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "405-326-8004",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creek Dental Group at Meadowbrook",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Allen
• Brenda Dionne Alley
• Niki Moleni Alusa
• Rand Alzahawi I
• American Current Care PA (Concentra Urgent Care)
• Saimoa Sam Amosa, AA, AS, BA
• Daely Andersen
• Kaitlyn Andreason
• Anh Tai Nguyen,MD
• Jon Richard Aoki, M.D.

• Dental Clinic/Center in West Valley City, UT
• Providers in West Valley City, 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 Jun 17, 2021; 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.