Millcreek PDC PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MILLCREEK PDC PLLC

Doing business as

Reason to Smile Dental

Practice address

4110 S Highland Dr Ste 100a
Millcreek, UT 84124-2784

Phone

(801) 506-6354

NPI assigned

Feb 28, 2023

Organization subpart

No

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

Authorized official

Name

Kayla Shade

Title

Revenue Cycle Manager

Phone

(801) 305-3460

Specialties & licenses 1

Addresses

Other names 1

• Reason to Smile Dental Doing business as

Locations

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1396444337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970681",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840970681",
            "telephone_number": "801-506-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 S HIGHLAND DR STE 100A",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841242784",
            "telephone_number": "801-506-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLCREEK PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "SHADE",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "801-305-3460"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reason to Smile Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madeline Meyer
• Kyleigh Mickolick
• Nicole Lenore Mihalopoulos, MD
• Millcreek Haven, LLC
• Millcreek Mind and Wellness
• Millcreek Therapy Psychological Services
• Alec Miller, MA
• Kaitlyn Miner, RBT
• Adam M Montgomery, CPSS
• Cristel Moreno, RBT

• Dental Clinic/Center in Millcreek, UT
• Providers in Millcreek, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.