DR. RUSSELL LYNN BOULTON DDS
NPI 1770709511
Dentist - General Practice in Holladay, UT

Q: What is Russell Boulton's NPI number?

The NPI number for Russell Boulton is 1770709511. It was assigned to this individual provider in the NPPES registry on April 18, 2007.

Q: What is Russell Boulton's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Russell Boulton was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 18, 2007PECOS Enrolled

2180 E 4500 S, #275, HOLLADAY, UT 84117(801) 277-9681 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Dr. Russell Lynn Boulton Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RUSSELL LYNN BOULTON DDS (NPI 1770709511) is an individual general practice provider in Holladay, Utah, licensed in Utah (131570) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770709511

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. RUSSELL LYNN BOULTONCredential: DDS

Location Address2180 E 4500 S, #275Holladay, UT 84117-4434

Mailing Address2180 E 4500 S, #275Holladay, UT 84117-4434 · (801) 277-9681

Phone(801) 277-9681

Sole ProprietorNo

Enumeration DateApril 18, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1770709511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in UT · 131570

Definition

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.

2180 E 4500 S, Holladay, UT 84117

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Russell Lynn Boulton Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84117 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CENTER FOR COUNSELING EXCELLENCE

Community/Behavioral Health

2180 E 4500 S, SUITE 105
HOLLADAY, UT 84117

Salt Lake County (801) 980-1343

KAITLYN SHYANNE WININGER LMT

Massage Therapist

2180 E 4500 S
HOLLADAY, UT 84117

Salt Lake County (801) 592-6588

DR. J. JOSHUA SMITH DMD

Dentist (General Practice)

2180 E 4500 S, SUITE #250
SALT LAKE CITY, UT 84117

Salt Lake County (801) 272-8609

SMART DENTAL CARE

Dentist

2180 E 4500 S
SALT LAKE CITY, UT 84117

Salt Lake County (801) 272-8609

GOLDEN HEALTH SERVICES

Hospice Care, Community Based

2180 E 4500 S, STE 210 F
HOLLADAY, UT 84117

Salt Lake County (801) 996-8690

MARK R BRIESACHER MD

Pediatrics

2180 E 4500 S, #210
SALT LAKE CITY, UT 84117

Salt Lake County (801) 278-4719

THE HEALING GROUP, PC

Community/Behavioral Health

2180 E 4500 S, SUITE 165
HOLLADAY, UT 84117

Salt Lake County (801) 461-9060

DR. JAYNE ELIZABETH CLARK M.D.

Physical Medicine & Rehabilitation

2180 E 4500 S, SUITE #185
HOLLADAY, UT 84117

Salt Lake County (801) 272-6972

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russell Boulton's NPI number?

The NPI number for Russell Boulton is 1770709511. It was assigned to this individual provider in the NPPES registry on April 18, 2007.

Where is Russell Boulton located?

Russell Boulton practices at 2180 E 4500 S #275, Holladay, UT 84117. The listed phone number is (801) 277-9681.

What is Russell Boulton's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Russell Boulton enrolled in Medicare?

Yes. Russell Boulton is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Russell Boulton was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.