NPIMap

Organization Active NPI

West Jordan Modern Dentistry , LLP

Doing business as West Jordan Modern Dentistry and Orthodontics

  • General Practice Dentistry
  • West Jordan, UT
National Provider Identifier
1508134412
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WEST JORDAN MODERN DENTISTRY , LLP
Doing business as
West Jordan Modern Dentistry and Orthodontics
Practice address
7632 Campus View Dr Ste 150
West Jordan, UT 84084-5630
Phone
(801) 282-4142
Fax
(801) 282-4146
NPI assigned
Dec 6, 2011
Last updated
Apr 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Authorized official

Name
Dr. Christine B. Goodell, DDSNPI 1750798542
Title
Owner
Phone
(801) 282-4142

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

7632 Campus View Dr Ste 150
West Jordan, UT 84084-5630

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8890

Other names 1

  • West Jordan Modern Dentistry and Orthodontics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2335285West Jordan Modern Dentistry and Orthodontics7632 Campus View Dr, Ste 150, West Jordan, UT 84084Certificate of waiverDec 8, 2027

National Provider Directory

National Provider Directory

Locations

7632 S Campus View Dr
Ste 150
West Jordan, UT 84084
Phone (801) 282-4142

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1508134412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7632 CAMPUS VIEW DR STE 150",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845630",
            "telephone_number": "801-282-4142",
            "fax_number": "801-282-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST JORDAN MODERN DENTISTRY , LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-06",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "GOODELL",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-282-4142",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Jordan Modern Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.