Individual provider Active NPI

Michael C Tew, D.D.S.

  • Pediatric Dentistry
  • West Jordan, UT
National Provider Identifier
1356306872
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5352062 Issued in UT
Practice address
3855 W 7800 S
#200
West Jordan, UT 84088-4314
Phone
(801) 282-1802
Fax
(801) 282-6244
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 5352062 UT Primary

Addresses

Primary practice location

3855 W 7800 S
#200
West Jordan, UT 84088-4314

Mailing address

3855 W 7800 S
#200
West Jordan, UT 84088-4314
Phone (801) 282-1802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5352062UTMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Crossing Pediatric Dentistry Pediatric Dentistry Current Accepting new patients
The Point Pediatric Dentistry. LLC Pediatric Dentistry CurrentSince May 1, 2025 Accepting new patients
Children's Landing Pediatric Dentistry, PC Pediatric Dentistry Current Accepting new patients

Locations

14629 S Porter Rockwell Blvd
Ste 104
Bluffdale, UT 84065
Phone (801) 890-1161

1528 N Commerce Dr
Ste 100
Saratoga Springs, UT 84045
Phone (801) 766-4900

3855 W 7800 S
Ste 200
West Jordan, UT 84088
Phone (801) 282-1802

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356306872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 W 7800 S",
            "address_2": "#200",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884314",
            "telephone_number": "801-282-1802",
            "fax_number": "801-282-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 W 7800 S",
            "address_2": "#200",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884314",
            "telephone_number": "801-282-1802",
            "fax_number": "801-282-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEW",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "5352062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.