South Ogen PDC PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTH OGEN PDC PLLC

Practice address

5300 Adams Ave Pkwy
Ogden, UT 84405-6902

Phone

(801) 476-1234

NPI assigned

Jun 6, 2020

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 1

Addresses

Locations

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

{
    "created_epoch": "1591401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591401600000",
    "number": "1649894486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970328",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840970309",
            "telephone_number": "801-476-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 ADAMS AVE PKWY",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056902",
            "telephone_number": "801-476-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH OGEN PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-06",
        "last_updated": "2020-06-06",
        "certification_date": "2020-06-06",
        "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": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven R Sorenson, LCSW
• John Nicholas Soter, MD
• Sound Sleep Medical LLC
• South Ogden Chiropractic Health
• South Ogden Dental PC
• Janet Southwick, COTA/L
• Jed Craig Southwick, M.D.
• Bronwen Southworth
• Franchesca Spangler, CSW
• Anjanette Spears

• General Practice Dentistry in Ogden, UT
• Providers in Ogden, 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 Jun 6, 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.