THE TOOTH DOCTOR (NPI# 1316172596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316172596 |
| Entity Type | Organization |
| Organization Name | THE TOOTH DOCTOR |
| Practice Address |
2180 E Fort Union Blvd. Salt Lake City UT 84121 |
| Practice Telephone | 8019444141 |
| Practice Fax Number | 8019446377 |
| Mailing Telephone | 8019444141 |
| Mailing Fax Number | 8019446377 |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2009-05-18 |
| Authorized Official Name | RAY E DILLMAN (OWNER) |
| Authorized Official Telephone | 8019444141 |
| Authorized Official Credential | D.D.S.,P.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 1395529922 | UT | Managed Care Organizations |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225432214 | The Tooth Doctor | Dentist | 4213 S Manhattan Ave, Tampa, FL 33611-1301 | 2014-10-20 |
| Street Address |
2180 E FORT UNION BLVD. |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578928172 | Sugar House Dental Management LLC | Preferred Provider Organization | 1955 S 1300 E Ste L2, Salt Lake City, UT 84105-3675 | 2015-12-23 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| 1689819526 | Comp Today Lc | Preferred Provider Organization | 480 E 6400 S Ste 100, Salt Lake City, UT 84107-7594 | 2008-12-05 |
| 1023483252 | Bishop Family Dental | Preferred Provider Organization | 2120 E 3900 S, Suite 102, Salt Lake City, UT 84124-1771 | 2015-12-14 |
| 1730517517 | Bkp Dental | Preferred Provider Organization | 4066 S 4000 W, Salt Lake City, UT 84120-4040 | 2013-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649820580 | Assertahealth Inc. | Preferred Provider Organization | 10421 S Jordan Gtwy Ste 660, South Jordan, UT 84095-3905 | 2019-09-12 |
| 1952841819 | Pinnacle Recovery Iop | Preferred Provider Organization | 9102 S 300 W, Sandy, UT 84070-2643 | 2017-02-26 |
| 1194273524 | New Horizon | Preferred Provider Organization | 1420 W 12600 Sputh, Draper, UT 84065 | 2016-09-14 |
| 1780037879 | Summit Senior Living LLC | Preferred Provider Organization | 5524 W 6200 S, Kearns, UT 84118-7925 | 2016-07-13 |
| 1790152551 | Helping Hands In-home Care LLC | Preferred Provider Organization | 690 N 3900 W, Cedar City, UT 84721-8130 | 2015-08-27 |
| 1407261506 | Utah Facial & Oral Surgery | Preferred Provider Organization | 3473 W South Jordan Pkwy, #4, South Jordan, UT 84095-6015 | 2014-06-26 |
| 1972928760 | Heros for Independent Living | Preferred Provider Organization | 655 Medical Dr, Suite 103, Bountiful, UT 84010-5168 | 2014-03-03 |
| 1265677678 | Edward K. Madsen, M.d., A Professional Corporation | Preferred Provider Organization | 590 E 100 N Ste 4, Price, UT 84501-2600 | 2008-12-14 |
| 1205008166 | James F. Allen, Mdpc | Preferred Provider Organization | 175 N 100 W Ste 101, Vernal, UT 84078-2057 | 2008-03-31 |
| 1760677520 | Ronald Baird | Preferred Provider Organization | 234 N Orem Blvd, Orem, UT 84057-6601 | 2007-09-13 |
| Find all providers with the same taxonomy | ||||
| City | SALT LAKE CITY |
| Zip Code | 84121 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.