NPIMap

Organization Active NPI

Ridge Park Dental

  • General Practice Dentistry
  • Layton, UT
National Provider Identifier
1982107306
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
275232 Issued in UT
Legal business name
RIDGE PARK DENTAL
Practice address
2307 N Hill Field Rd Ste 101
Layton, UT 84041-6890
Phone
(801) 773-5285
Fax
(801) 773-2850
NPI assigned
Mar 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dr. Grant Atwood Brough, DDSNPI 1821182098
Title
Owner/Operator
Phone
(801) 773-5285

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 275232 UT Primary

Addresses

Primary practice location

2307 N Hill Field Rd Ste 101
Layton, UT 84041-6890

Mailing address

2307 N Hill Field Rd Ste 101
Layton, UT 84041-6890
Phone (801) 773-5285

Other names 2

  • Dr. Grant A. Brough, DDS, PC Former legal business name
  • Grant A Brough, DDS, PC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Dr Grant a Brough DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1982107306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 N HILL FIELD RD STE 101",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840416890",
            "telephone_number": "801-773-5285",
            "fax_number": "801-773-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 N HILL FIELD RD STE 101",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840416890",
            "telephone_number": "801-773-5285",
            "fax_number": "801-773-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE PARK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "BROUGH",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "ATWOOD",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "801-773-5285",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "275232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Grant A. Brough, DDS, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Grant A Brough, DDS, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.