Active NPI
Christopher Robertson
- General Practice Dentistry
- Roy, UT
National Provider Identifier
1992165252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 107713219921
- Practice address
- 4902 S 1900 W Ste 2
Roy, UT 84067-2961 - Phone
- (801) 773-1234
- NPI assigned
- Feb 29, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 107713219921 | UT | Primary |
Addresses
Primary practice location
4902 S 1900 W Ste 2
Roy, UT 84067-2961
Mailing address
345 E 24TH St
New York, NY 10010-4020
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
| License | State | Type | Specialty |
|---|---|---|---|
| 107713219921 | UT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567641600000",
"number": "1992165252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 E 24TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100104020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4902 S 1900 W STE 2",
"city": "ROY",
"state": "UT",
"postal_code": "840672961",
"telephone_number": "801-773-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "CHRISTOPHER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-29",
"last_updated": "2019-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "107713219921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.