Organization Active NPI

Mountain View Dental PDC PLLC

Doing business as Mountain View Dental

  • Dentist
  • South Jordan, UT
National Provider Identifier
1225673429
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MOUNTAIN VIEW DENTAL PDC PLLC
Doing business as
Mountain View Dental
Practice address
6783 S Redwood Rd #201
South Jordan, UT 84084-5743
Phone
(801) 969-8200
NPI assigned
Nov 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Jacob Warner
Title
Credentialing Manager
Phone
(801) 691-1701

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

6783 S Redwood Rd #201
South Jordan, UT 84084-5743

Mailing address

PO Box 970057
Orem, UT 84097-0309
Phone (801) 305-3460

Other names 1

  • Mountain View Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1225673429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970057",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840970309",
            "telephone_number": "801-305-3460",
            "fax_number": "801-335-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6783 S REDWOOD RD #201",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840845743",
            "telephone_number": "801-969-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW DENTAL PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-12",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "801-691-1701"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain View Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain View Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.