Bullen & Wilson Eaglegate College Dental Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

133186-9922 Issued in UT

Legal business name

BULLEN & WILSON EAGLEGATE COLLEGE DENTAL CLINIC

Practice address

5618 Green St
Murray, UT 84123-5796

Phone

(801) 333-8138

Fax

(801) 263-6520

NPI assigned

Aug 31, 2009

Last updated

Aug 31, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

BULLEN & WILSON EAGLEGATE COLLEGEAs reported in NPPES

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

Authorized official

Name

Ms. Holli D Stewart, CDA

Title

Clinic Manager

Phone

(801) 333-8138

Specialties & licenses 1

Addresses

Part of

Bullen Wilson Eaglegate College Dental Clinic

Locations

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251676800000",
    "number": "1962635466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5618 GREEN ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235796",
            "telephone_number": "801-333-8138",
            "fax_number": "801-263-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5618 GREEN ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235796",
            "telephone_number": "801-333-8138",
            "fax_number": "801-263-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULLEN & WILSON EAGLEGATE COLLEGE DENTAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BULLEN & WILSON EAGLEGATE COLLEGE",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "HOLLI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "801-333-8138",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CDA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "133186-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvin Buck
• Nathan Scott Buck, MD
• Maggie Buckhannon, SLP
• Aaron Buckner
• Sabrina Bulkley
• Emily Ann Bullock, FNP
• Jared Cole Bumgardner, A.U.D
• Maren Rose Bunch, RDN
• Brandon S Bunker, LCMHC
• Burg Pediatric Dentistry

• General Practice Dentistry in Murray, UT
• Providers in Murray, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.