Individual provider Active NPI

Richard Owen Woodward, D.D.S.

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1972602019
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
131873-9921 Issued in UT
Practice address
3195 S Main St Ste 200
Salt Lake City, UT 84115-3749
Phone
(801) 468-0342
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 131873-9921 UT Primary

Addresses

Primary practice location

3195 S Main St Ste 200
Salt Lake City, UT 84115-3749

Mailing address

6751 Olivet Dr
Salt Lake City, UT 84121-2712
Phone (801) 943-4625

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

LicenseStateTypeSpecialty
131873-9921UTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1972602019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6751 OLIVET DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841212712",
            "telephone_number": "801-943-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 S MAIN ST STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153749",
            "telephone_number": "801-468-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "RICHARD",
        "middle_name": "OWEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "131873-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.