NPIMap

Organization Active NPI

Kids Town Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Roy, UT
National Provider Identifier
1992253991
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
6348475 Issued in UT
Legal business name
KIDS TOWN PEDIATRIC DENTISTRY, PLLC
Practice address
3540 W 6000 S
Suite 200
Roy, UT 84067-9071
Phone
(801) 217-3359
Fax
(801) 217-3950
NPI assigned
Sep 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Authorized official

Name
Aimee Orton
Title
Financial Manager
Phone
(801) 217-3359

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 6348475 UT Primary

Addresses

Primary practice location

3540 W 6000 S
Suite 200
Roy, UT 84067-9071

Mailing address

3540 W 6000 S
Suite 200
Roy, UT 84067-9071
Phone (801) 217-3359

Other names 1

  • Kids Town Pediatric Dentistry Roy Other name

National Provider Directory

National Provider Directory
Tax ID family
Kids Town Pediatric Dentistry3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

3540 W 6000 S
#200
Roy, UT 84067
Phone (801) 217-3359

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": "1474243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1992253991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 W 6000 S",
            "address_2": "SUITE 200",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679071",
            "telephone_number": "801-217-3359",
            "fax_number": "801-217-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 W 6000 S",
            "address_2": "SUITE 200",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679071",
            "telephone_number": "801-217-3359",
            "fax_number": "801-217-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS TOWN PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "ORTON",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "801-217-3359"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "6348475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Town Pediatric Dentistry Roy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 20, 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.