Jordan Ridge Pediatric Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JORDAN RIDGE PEDIATRIC DENTISTRY

Practice address

678 E. Vine Street
Suite #10
Murray, UT 84107

Phone

(801) 918-4135

NPI assigned

Aug 28, 2016

Organization subpart

No

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

Authorized official

Name

Marci Nicol

Title

VP of Operations

Phone

(801) 918-4135

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472342400000",
    "number": "1669928909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 E VINE ST",
            "address_2": "SUITE #10",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075546",
            "telephone_number": "801-918-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 E. VINE STREET",
            "address_2": "SUITE #10",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-918-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN RIDGE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A",
        "authorized_official_last_name": "NICOL",
        "authorized_official_first_name": "MARCI",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "801-918-4135"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Luke Jones, DPM
• Russ Jones
• Stephen Merrill Jones, AU-D
• Tamara B. Jones, CMHC
• Travis Jones, M.D.
• Kaila Jordan
• Allie Jorgensen
• Tracy Joy, SSW
• David Paul Jubelirer, M.D.
• Heather Ann Judd, LCMHC

• Dental Clinic/Center in Murray, UT
• Providers in Murray, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; 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.