PDC Riverton LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PDC RIVERTON LLC

Doing business as

Platinum Dental Care

Practice address

2364 W 12600 S
Ste 1a
Riverton, UT 84065-7109

Phone

(801) 253-8866

NPI assigned

Apr 26, 2016

Organization subpart

No

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

Authorized official

Name

Taelor Jeppson

Title

Insurance Coordinator

Phone

(801) 305-3460

Specialties & licenses 2

Addresses

Other names 1

• Platinum Dental Care Doing business as

Locations

Practitioners 1

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

• David Jay Johnson, DMD

  • Pediatric Dentistry
  • Riverton, UT
  • NPI 1831165224
  NPD (past)

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1306291422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2476 N UNIVERSITY PKWY STE 201",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043869",
            "telephone_number": "801-305-3460",
            "fax_number": "801-692-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 W 12600 S",
            "address_2": "STE 1A",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657109",
            "telephone_number": "801-253-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDC RIVERTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "JEPPSON",
        "authorized_official_first_name": "TAELOR",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "801-305-3460"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Platinum Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nichole Patrick, LCMHC
• Richard McCurry Patten, M.D.
• Jocelyn Patterson, CERTIFIED CASE MNGR
• Paula Lynn Paulson, INTERN
• Amanda L Pay, AUD
• Jennifer J. Peacock, DNP, APRN, NNP-BC
• Haley H Pedersen, FNP-C
• Pediatric Inpatient Services Riverton
• Kenna Renee Peters, PT
• Rylee Petersen

• General Practice Dentistry in Riverton, UT
• Providers in Riverton, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.