SGWJ Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SGWJ DENTAL PLLC

Practice address

6973 S Cougar LN Ste D
West Jordan, UT 84084-7927

Phone

(801) 982-0332

NPI assigned

Jul 21, 2025

Organization subpart

No

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

Authorized official

Name

Dr. James Spencer Gruber, DMDNPI 1083279764

Title

Dentist

Phone

(801) 718-6881

Specialties & licenses 1

Addresses

Other names 1

• Jordan Ridge Dental Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 4

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

• James Spencer Gruber, DMD

  • General Practice Dentistry
  • Wendover, UT
  • NPI 1083279764
  Medicare reassignment NPD Authorized official
• Kim-Loan Nguyen, DDS

  • General Practice Dentistry
  • Holladay, UT
  • NPI 1528620390
  Medicare reassignment NPD
• Bianca Bernardo Afonso Aguirres, DMD

  • Dentist
  • West Jordan, UT
  • NPI 1487580569
  NPD (past)
• Wells Wesley Wagner, D.D.S.

  • General Practice Dentistry
  • West Jordan, UT
  • NPI 1225176381
  NPD (past)

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

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753056000000",
    "number": "1457243784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3569 W 10305 S",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6973 S COUGAR LN STE D",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840847927",
            "telephone_number": "801-982-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SGWJ DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-20",
        "status": "A",
        "authorized_official_last_name": "GRUBER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "SPENCER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "801-718-6881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jordan Ridge Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher David Selin, CRNA
• Guillermina Serrano
• Sonya-Mae Servin
• Wade M Sessions, MD
• Tina Severson
• Devery Ann Shaddy, FNP
• Shadow Mountain Family Medicine LLC
• Shadow Mountain Family Physicians
• Ashton Thomas Shaw
• Laurie N Shaw

• Dental Clinic/Center in West Jordan, UT
• Providers in West Jordan, 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 Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.