Provider Type Icon

BLUE MOUNTAIN FAMILY DENTAL NPI 1003206350

NPI Profile

NPI: 1003206350
Provider Name: BLUE MOUNTAIN FAMILY DENTAL
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1675 N 200 W #8A
PROVO, UT
ZIP 84604
Get Directions

Phone: (801) 356-7329

BLUE MOUNTAIN FAMILY DENTAL is a general practice dentist in Provo, UT. The provider is 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. BLUE MOUNTAIN FAMILY DENTAL NPI is 1003206350. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1675 N 200 W #8A
PROVO, UT
ZIP 84604
Phone: (801) 356-7329

The provider's authorized official is Justin Todd Hilmo .
The authorized official title is General Dentist and has the following contact phone number (801) 356-7329.

The enumeration date for this NPI number is 1/26/2015 and was last updated on 1/26/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice7369645UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1050828MEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 6/4/2020

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.