NPIMap

Organization Active NPI

Modern Dental Professionals Utah, PC

  • General Practice Dentistry
  • Sandy, UT
National Provider Identifier
1487913869
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MODERN DENTAL PROFESSIONALS UTAH, PC
Practice address
10011 S Centennial Pkwy Ste 330
Sandy, UT 84070-4178
Phone
(801) 256-3700
Fax
(801) 576-1777
NPI assigned
May 7, 2012
Reactivated
Jan 6, 2025
Organization subpart
Yes
Parent organization
MODERN DENTAL PROFESSIONALS UTAH, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Gregory Smith
Title
Owner
Phone
(801) 955-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

10011 S Centennial Pkwy Ste 330
Sandy, UT 84070-4178

Mailing address

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

Other names 1

  • Monarch Dental - Sandy 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
Part of
Modern Dental Professionals Utah PC

Other organizations with this tax ID 9

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

Locations

280 N Union Ave
#L110
Farmington, UT 84025

10011 S Centennial Pkwy
Ste 330
Sandy, UT 84070
Phone (801) 256-3700

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1336348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1487913869",
    "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": "10011 S CENTENNIAL PKWY STE 330",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704178",
            "telephone_number": "801-256-3700",
            "fax_number": "801-576-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL PROFESSIONALS UTAH, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MODERN DENTAL PROFESSIONALS UTAH, PC",
        "enumeration_date": "2012-05-07",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "deactivation_date": "2024-04-08",
        "reactivation_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-955-1900"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monarch Dental - Sandy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.