Healthcare Provider Details

I. General information

NPI: 1811283369
Provider Name (Legal Business Name): SCOTT C. NORD D.M.D M.S P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 E UNIVERSITY PKWY
OREM UT
84058-7638
US

IV. Provider business mailing address

291 E UNIVERSITY PKWY
OREM UT
84058-7638
US

V. Phone/Fax

Practice location:
  • Phone: 801-225-7141
  • Fax: 801-225-0551
Mailing address:
  • Phone: 801-225-7141
  • Fax: 801-225-0551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number5342094-9921
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. SCOTT C. NORD
Title or Position: OWNER
Credential: M.D.
Phone: 801-225-7141