DR. JEREMY GRANT GODDERIDGE (NPI# 1508978826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508978826 |
| Entity Type | Individual |
| Full Name | DR. JEREMY GRANT GODDERIDGE |
| Credential | D.D.S |
| Practice Address |
1792 W 1700 S Syracuse UT 84075-9143 |
| Mailing Address |
1352 Doral Dr Syracuse UT 84075-9739 |
| Practice Telephone | 8016985892 |
| Mailing Telephone | 8017738579 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-06-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6250404-9922 | UT | Dental Providers |
| Street Address |
1792 W 1700 S |
| City | SYRACUSE |
| State | UT |
| Zip Code | 84075-9143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295733343 | Peter Edward Silas | Pediatrics | 1792 W 1700 S, Suite 108, Syracuse, UT 84075-9650 | 2005-07-12 |
| 1366617110 | Kelson Physician Partners of Layton, Inc. Dba Wee Care Pediatrics | Pediatrics | 1792 W 1700 S, Syracuse, UT 84075-9143 | 2008-04-23 |
| 1457535114 | Cody J Hawkes | Pediatrics | 1792 W 1700 S, Suite 108, Syracuse, UT 84075-9650 | 2007-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750775235 | Syracuse Assisted Living Phase I | Assisted Living Facility | 2063 W. 1900 S., Syracuse, UT 84075 | 2015-03-24 |
| 1881975464 | Norman Kent Sharp II | Dentist | 1662 S 2000 W Ste A1, Syracuse, UT 84075 | 2011-09-08 |
| 1245471705 | Ihc Health Services Inc | Family Medicine | 745 South 2000 West, Syracuse, UT 84075 | 2009-03-13 |
| 1124240197 | Richard Jackson | Psychologist | 2650 West 2700 South, Syracuse, UT 84075 | 2007-05-02 |
| 1679799902 | Nathan Wesley Elmore | Chiropractor | 1842 South 2000 West, Syracuse, UT 84075 | 2007-04-17 |
| 1972635332 | Aspen Institute for Behavioral Assessment | Psychiatric Residential Treatment Facility | 2732 W 2700 S, Syracuse, UT 84075 | 2007-03-12 |
| 1427111558 | Sheldon L Peck | Dentist | 1747 S Heritage Lane, Suite A3, Syracuse, UT 84075 | 2006-12-19 |
| 1811081771 | Tyler R Elmore | Chiropractor | 1013 W 2700 S, Syracuse, UT 84075 | 2006-10-03 |
| 1235247438 | Brett R Coleman | Dentist | 780 S 2000 W, Bldg E304, Syracuse, UT 84075 | 2006-08-28 |
| 1164431177 | Kipton Jay Norris | Dentist | 1747 S. Heritage Ln, Suite B-201, Syracuse, UT 84075 | 2006-08-07 |
| Find all providers in zip 84075 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588211262 | Gerald F. Danaher Dds | Dentist | 5298 Terry Rd, Syracuse, NY 13219-3066 | 2019-08-19 |
| 1134501356 | Gideon Ochiabuto Dentistry PC | Dentist | 521 E Washington St, Syracuse, NY 13202-1917 | 2015-06-24 |
| 1275891731 | Jeffrey Val Hansen | Dentist | 1747 Heritage Ln Ste B203, Syracuse, UT 84075-8532 | 2012-05-02 |
| 1881975464 | Norman Kent Sharp II | Dentist | 1662 S 2000 W Ste A1, Syracuse, UT 84075 | 2011-09-08 |
| 1982922092 | Chung-lei Kao | Dentist | 910 Erie Blvd E., Syracuse, NY 13210 | 2010-05-13 |
| 1447412705 | Randall Steven Cory | Dentist | 801 N Huntington St, Suite 11, Syracuse, IN 46567-1151 | 2008-06-27 |
| 1316113681 | Mireille Cruz | Dentist | 5217 S Salina St, Syracuse, NY 13205-3019 | 2008-05-06 |
| 1245444025 | Thomas Anthony Osinski | Dentist | 201 Cumberland Pl, Syracuse, NY 13210-3154 | 2007-05-10 |
| 1043331549 | Joan Lura Armstrong | Dentist | 437 Allen St, Syracuse, NY 13210-2201 | 2007-04-02 |
| 1063532554 | Michael Burke Mcgrath | Dentist | 5108 Velasko Rd, Syracuse, NY 13215-1953 | 2007-03-30 |
| Find all providers in SYRACUSE | ||||
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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.