North Logan PDC PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

NORTH LOGAN PDC PLLC

Doing business as

Platinum Dental Care

Practice address

1445 N 400 E Ste 3a
Logan, UT 84341-7564

Phone

(435) 752-1699

NPI assigned

May 29, 2019

Organization subpart

No

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

Authorized official

Name

Jacob Warner

Title

Credentialing Manager

Phone

(801) 691-1701

Specialties & licenses 2

Addresses

Other names 1

• Platinum Dental Care Doing business as

Locations

Practitioners 1

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

• Rodney Tyson Gardner I, DMD

  • Dentist
  • Tremonton, UT
  • NPI 1144710781
  NPD (past)

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1649837337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970184",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840970309",
            "telephone_number": "901-305-3460",
            "fax_number": "801-335-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 N 400 E STE 3A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843417564",
            "telephone_number": "435-752-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LOGAN PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "801-691-1701"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Platinum Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeannine Deborah Nielson, MS
• Christian D Nilson, MD PC
• Nolan a. White, D.C., P.C.
• Barry A Noorda, MD
• Cheryl Norr
• Northern Utah Endoscopy Center
• Northern Utah Eye Center
• Northern Utah Gastroenterology and Endoscopy Specialists LLC
• Northern Utah Pathology PC
• Northern Utah Surgery Center, LLC

• Dentist in Logan, UT
• Providers in Logan, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.