NPIMap

Organization Active NPI

CC Dental PLLC

  • Dental Clinic/Center
  • Cedar City, UT
National Provider Identifier
1285328013
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CC DENTAL PLLC
Practice address
1883 W Royal Hunte Dr Ste 100
Cedar City, UT 84720-4086
Phone
(435) 586-6541
Fax
(435) 304-6161
NPI assigned
Jun 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Holly Pedersen
Title
Office Manager
Phone
(435) 586-6541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1883 W Royal Hunte Dr Ste 100
Cedar City, UT 84720-4086

Mailing address

1883 W Royal Hunte Dr Ste 100
Cedar City, UT 84720-4086
Phone (435) 586-6541

Other names 1

  • Cedar Dental Center Other name

National Provider Directory

National Provider Directory

Locations

1883 W Royal Hunte Dr
Ste 100
Cedar City, UT 84720
Phone (435) 586-6541

Practitioners & affiliated clinicians

Practitioners 3

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": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1285328013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1883 W ROYAL HUNTE DR STE 100",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847204086",
            "telephone_number": "435-586-6541",
            "fax_number": "435-304-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1883 W ROYAL HUNTE DR STE 100",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847204086",
            "telephone_number": "435-586-6541",
            "fax_number": "435-304-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CC DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "435-586-6541"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Dental Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cedar City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.