NPIMap

Organization Active NPI

Red Pine Dental

  • Dental Clinic/Center
  • West Valley, UT
National Provider Identifier
1992384366
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
RED PINE DENTAL
Practice address
3550 S 5600 W Ste 3
West Valley, UT 84120-2778
Phone
(801) 966-3166
NPI assigned
Apr 5, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Authorized official

Name
David Jackson, DDSNPI 1629165170
Title
Owner
Phone
(801) 966-3166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3550 S 5600 W Ste 3
West Valley, UT 84120-2778

Mailing address

3550 S 5600 W Ste 3
West Valley, UT 84120-2778
Phone (801) 966-3166

National Provider Directory

National Provider Directory

Locations

3550 S 5600 W
Ste 3
West Valley City, UT 84120
Phone (801) 966-3166

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": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1992384366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 S 5600 W STE 3",
            "city": "WEST VALLEY",
            "state": "UT",
            "postal_code": "841202778",
            "telephone_number": "801-966-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 S 5600 W STE 3",
            "city": "WEST VALLEY",
            "state": "UT",
            "postal_code": "841202778",
            "telephone_number": "801-966-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED PINE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-966-3166",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.