Individual provider Active NPI

Bart L Goldsberry, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Salt Lake City, UT
National Provider Identifier
1982777439
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
96-317730-9921 Issued in UT
Practice address
223 S 700 E
Salt Lake City, UT 84102-2171
Phone
(801) 359-5264
Fax
(801) 359-5265
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 96-317730-9921 UT Primary

Addresses

Primary practice location

223 S 700 E
Salt Lake City, UT 84102-2171

Mailing address

223 S 700 E
Salt Lake City, UT 84102-2171
Phone (801) 359-5264

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
96-317730-9921UTMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982777439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022171",
            "telephone_number": "801-359-5264",
            "fax_number": "801-359-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022171",
            "telephone_number": "801-359-5264",
            "fax_number": "801-359-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSBERRY",
        "first_name": "BART",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "96-317730-9921",
            "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 Jul 8, 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.