South Ogden Smiles, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTH OGDEN SMILES, PC

Practice address

5856 Harrison Blvd Ste B
South Ogden, UT 84403-2117

Phone

(801) 475-7776

Fax

(801) 475-5865

NPI assigned

Nov 5, 2020

Organization subpart

Yes

Parent organization

SOUTH OGDEN SMILES, PCAs reported in NPPES

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

Authorized official

Name

Patrick McNeal Tanner, DMDNPI 1790904217

Title

Owner

Phone

(801) 389-0053

Specialties & licenses 1

Addresses

Part of

South Ogden Smiles PC

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patrick McNeil Tanner, DMD

  • Dentist
  • South Ogden, UT
  • NPI 1790904217
  NPD Authorized official
• Justin Cook, DDS

  • General Practice Dentistry
  • Roy, UT
  • NPI 1023375417

  General Practice

  NPD (past)

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1992306922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5856 HARRISON BLVD STE B",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844032117",
            "telephone_number": "801-475-7776",
            "fax_number": "801-475-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5856 HARRISON BLVD STE B",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844032117",
            "telephone_number": "801-475-7776",
            "fax_number": "801-475-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH OGDEN SMILES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH OGDEN SMILES, PC",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "MCNEAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-389-0053",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Smith, RBT
• Lori Smith
• Megan Davis Smith, BCBA
• South Ogden City Corporation
• South Ogden Operations, LLC
• South Ogden Specialty Surgical Center, LLC
• Specialized Optical Company
• Stephen Reese Spencer, PT
• Fereti Spitzenberg Jr.
• Jayne Deane Sprafke, LCSW

• All providers in South Ogden, UT
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.