Mountain Ridge Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MOUNTAIN RIDGE DENTAL, LLC

Practice address

1256 S State St
Suite 103
Orem, UT 84097-8237

Phone

(801) 224-7182

Fax

(801) 235-0835

NPI assigned

Jan 10, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Delahunt

Title

Owner/Manager

Phone

(801) 224-7182

Specialties & licenses 1

Addresses

Practitioners 2

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

• Juan C. Chavez, D.M.D.

  • General Practice Dentistry
  • Orem, UT
  • NPI 1295033843
  NPD (past)
• Ryan Schofield Wing, DDS

  • Pediatric Dentistry
  • Spanish Fork, UT
  • NPI 1104003102
  NPD (past)

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457330458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 S STATE ST",
            "address_2": "SUITE 103",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840978237",
            "telephone_number": "801-224-7182",
            "fax_number": "801-235-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 S STATE ST",
            "address_2": "SUITE 103",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840978237",
            "telephone_number": "801-224-7182",
            "fax_number": "801-235-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN RIDGE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DELAHUNT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "801-224-7182",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucas James Moulton, LCSW, CRC, LVRC
• Shayla Moulton, PTA
• VA Sharon Mounga, FNP-C
• Mountain Peaks Family Practice LC
• Mountain Peaks Recovery Foundation
• Mountain View Anesthesia LC
• Mountain View Chiropractic Center, PLLC
• Mountain View Retirement, Inc.
• Mountain View Retirement, Inc.
• Mountainland Association of Government

• General Practice Dentistry in Orem, UT
• Providers in Orem, 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 Aug 22, 2020; 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.