Falling Creek Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7015094 Issued in UT

Legal business name

FALLING CREEK DENTAL LLC

Practice address

112 E 12450 S Ste 101
Draper, UT 84020-8057

Phone

(801) 495-3567

NPI assigned

Nov 1, 2016

Organization subpart

No

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

Authorized official

Name

Chad M Goerckeritz

Title

Owner

Phone

(801) 495-3567

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1992257372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E 12450 S STE 101",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 12450 S STE 101",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208057",
            "telephone_number": "801-495-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLING CREEK DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "GOERCKERITZ",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-495-3567"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "7015094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Faber, LCSW
• Sara Fabry
• Kelly A Faddis, DDS
• Camilla Falatea
• Atu Tonga Maile Falevai, CSW
• Alyssa Isabel Fallon
• Kimberly Farley
• Kelly Reese Farmer
• Rebecca Ann Farnsworth, APRN
• Hannah Farnworth, LMFT

• General Practice Dentistry in Draper, UT
• Providers in Draper, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.