DR. CHAD KELLY BOOTH (NPI# 1942464078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942464078 |
| Entity Type | Individual |
| Full Name | DR. CHAD KELLY BOOTH |
| Credential | D.M.D. |
| Practice Address |
589 South State Street Provo UT 84606-5056 |
| Practice Telephone | 8014292000 |
| Practice Fax Number | 8014292001 |
| Mailing Telephone | 8014292000 |
| Mailing Fax Number | 8014292001 |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2020-04-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 6977043-9923 | UT | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
6977043 | UT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225154610 | Chad Booth | Chiropractor | 1224 Harris Ave, Suite 107, Bellingham, WA 98225-7152 | 2007-03-21 |
| 1477861920 | Chad Eric Booth | Pharmacist | 7271 Wall Triana Hwy, Madison, AL 35757-8002 | 2010-09-17 |
| 1083802094 | Chad A Booth | Social Worker | 450 Saint John Rd, Michigan City, IN 46360-7354 | 2007-10-04 |
| Street Address |
589 SOUTH STATE STREET |
| City | PROVO |
| State | UT |
| Zip Code | 84606-5056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396765376 | Vernon White | Family Medicine | 589 South State Street, Provo, UT 84606-5056 | 2006-07-20 |
| 1699000570 | Karmin Bell | Nurse Practitioner | 589 South State Street, Provo, UT 84606-5056 | 2009-10-09 |
| 1588877674 | Pahl Bench | Family Medicine | 589 South State Street, Provo, UT 84606-5056 | 2007-05-07 |
| 1952491557 | Salvador Fernandez | Family Medicine | 589 South State Street, Provo, UT 84606-5056 | 2006-10-13 |
| 1659391704 | Bruce Grover | Family Medicine | 589 South State Street, Provo, UT 84606-5056 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935551 | Olivia Stiles | Specialist/Technologist | 200 E 515 N, Provo, UT 84606 | 2020-06-01 |
| 1417439076 | Quin Spencer Volpe | Counselor | 1035 E 560 N, Provo, UT 84606 | 2018-08-30 |
| 1700365434 | Hyunwook Lee | Specialist/Technologist | 1369 S 1500 E, Provo, UT 84606 | 2018-08-13 |
| 1598268930 | Victor Bert Arthur Moxley | Specialist | 290 N 300 E, Provo, UT 84606 | 2018-03-12 |
| 1184132623 | Academy Dental LLC | Advanced Practice Dental Therapist | 488 N 100 E St., Provo, UT 84606 | 2018-01-18 |
| 1720433485 | Sean Lamb | Counselor | 231 S. 100 E., Provo, UT 84606 | 2016-05-02 |
| 1508236795 | Forever Young Dentistry Pllc | Clinic/Center | 2335 S. State Street, Ste #200, Provo, UT 84606 | 2015-09-30 |
| 1558766014 | Nancy Huber | Physician Assistant | Mountainland Community Health Center, 529 South State Street, Provo, UT 84606 | 2014-10-27 |
| 1356778377 | Myrna Suzanne Gillis | Marriage & Family Therapist | 1726 Buckley Drive, Provo, UT 84606 | 2013-10-04 |
| 1558651067 | Melissa Anne Mccreary | Counselor | 151 S.state St. University Ave., Ste 1400, Provo, UT 84606 | 2011-04-18 |
| Find all providers in zip 84606 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811462120 | Dr Quinn Schiffman Dds LLC | Dentist | 1355 N University Ave Ste 320, Provo, UT 84604-2721 | 2018-10-12 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1144602970 | Tyra Neal | Dentist | 1450 W 820 N, Provo, UT 84601-1305 | 2015-06-29 |
| 1427437144 | Mountainlands Community Health Center, Inc. | Dentist | 299 E 900 S Ste 101, Provo, UT 84606-6107 | 2015-05-27 |
| 1730586355 | Juan C. Chavez, D.m.d., P.l.l.c | Dentist | 2520 N University Ave Ste 101, Provo, UT 84604-6081 | 2014-11-25 |
| 1174938294 | Michael Aaron Merkley | Dentist | 777 N 500 W # 201, Provo, UT 84601-1541 | 2014-06-26 |
| 1053613497 | Jones Dental | Dentist | 3651 N 100 E Ste 200, Provo, UT 84604-4553 | 2010-11-17 |
| 1083876205 | R. Reed Call | Dentist | 777 N 500 W Ste 202, Provo, UT 84601-1541 | 2008-06-29 |
| 1144422429 | Grandpa's Dental Inc. | Dentist | 777 North 500 West, 201b, Provo, UT 84601-1570 | 2007-05-31 |
| 1386770915 | Dean F Robinson | Dentist | 2476 N University Pky #102, Provo, UT 84604-3801 | 2007-02-26 |
| Find all providers in PROVO | ||||
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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.