NPIMap

Organization Active NPI

MSG Dental LLC

  • General Practice Dentistry
  • Provo, UT
National Provider Identifier
1982155909
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8372408-9922 Issued in UT
Legal business name
MSG DENTAL LLC
Practice address
835 N 700 E
Provo, UT 84606-6993
Phone
(801) 373-7700
NPI assigned
Oct 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Authorized official

Name
Dr. Todd C Groesbeck, DMD
Title
Dentist
Phone
(801) 373-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 8372408-9922 UT Primary

Addresses

Primary practice location

835 N 700 E
Provo, UT 84606-6993

Mailing address

835 N 700 E
Provo, UT 84606-6993
Phone (801) 373-7700

Other names 1

  • Cougar Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cougar Dental2 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.

Locations

835 N 700 E
Provo, UT 84606
Phone (801) 373-7700

NPI Registry JSON

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1982155909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 N 700 E",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846066993",
            "telephone_number": "801-373-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 N 700 E",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846066993",
            "telephone_number": "801-373-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSG DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "GROESBECK",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "801-373-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "8372408-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cougar Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.