NPIMap

Organization Active NPI

Modern Dental Professionals - Utah, PC

Doing business as Monarch Dental - Taylorsville

  • Dentist
  • Taylorsville, UT
National Provider Identifier
1437556404
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MODERN DENTAL PROFESSIONALS - UTAH, PC
Doing business as
Monarch Dental - Taylorsville
Practice address
5419 S Redwood Rd Ste 2
Taylorsville, UT 84123-6957
Phone
(801) 263-6400
Fax
(801) 294-8551
NPI assigned
Nov 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Authorized official

Name
Liliana Martinez
Title
Credentialing Director
Phone
(949) 308-9792

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5419 S Redwood Rd Ste 2
Taylorsville, UT 84123-6957

Mailing address

8415 Datapoint Dr Ste 1020
San Antonio, TX 78229-3277
Phone (210) 929-2814

Other names 1

  • Monarch Dental - Taylorsville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Modern Dental Professionals Utah PC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5419 S Redwood Rd
Ste 2
Taylorsville, UT 84123
Phone (801) 263-6400

NPI Registry JSON

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1437556404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 DATAPOINT DR STE 1020",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293277",
            "telephone_number": "210-929-2814",
            "fax_number": "210-615-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5419 S REDWOOD RD STE 2",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841236957",
            "telephone_number": "801-263-6400",
            "fax_number": "801-294-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL PROFESSIONALS - UTAH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-19",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LILIANA",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "949-308-9792"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monarch Dental - Taylorsville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylorsville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.