Organization Active NPI

Abundant Dental Care LLC

Doing business as Abundant Dental Care of Fort Union

  • General Practice Dentistry
  • Cottonwood Heights, UT
National Provider Identifier
1033900683
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ABUNDANT DENTAL CARE LLC
Doing business as
Abundant Dental Care of Fort Union
Practice address
6957 S 1300 E
Cottonwood Heights, UT 84047-1817
Phone
(801) 747-8015
NPI assigned
May 14, 2025
Last updated
May 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ABUNDANT DENTAL CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tracie Sullivan
Title
VP of Finance
Phone
(801) 849-1045

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

6957 S 1300 E
Cottonwood Heights, UT 84047-1817

Mailing address

793 E Winchester St
Murray, UT 84107-7564
Phone (801) 849-1045

Other names 1

  • Abundant Dental Care of Fort Union Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Abundant Dental Care PC12 organizations share this tax ID, including this one
Part of
Abundant Dental Care PC

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1033900683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 E WINCHESTER ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077564",
            "telephone_number": "801-849-1045",
            "fax_number": "801-304-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6957 S 1300 E",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "840471817",
            "telephone_number": "801-747-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABUNDANT DENTAL CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ABUNDANT DENTAL CARE LLC",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "801-849-1045"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abundant Dental Care of Fort Union",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cottonwood Heights, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.