Organization Active NPI

Daybreak PDC PLLC

  • Dentist
  • South Jordan, UT
National Provider Identifier
1699317685
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DAYBREAK PDC PLLC
Doing business as
Platinum Dental Care
Practice address
4040 West Daybreak Pkwy
Suite 103
South Jordan, UT 84009-1286
Phone
(385) 279-4334
Fax
(385) 212-3268
NPI assigned
Oct 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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
(385) 279-4334

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

4040 West Daybreak Pkwy
Suite 103
South Jordan, UT 84009-1286

Mailing address

PO Box 970325
Orem, UT 84097-0309
Phone (801) 305-3460

Other names 1

  • Platinum Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

4040 W Daybreak Pkwy
Ste 103
South Jordan, UT 84009
Phone (385) 279-4334

Practitioners & affiliated clinicians

Practitioners 1

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": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570752000000",
    "number": "1699317685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970325",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840970309",
            "telephone_number": "801-305-3460",
            "fax_number": "801-335-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 WEST DAYBREAK PKWY",
            "address_2": "SUITE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840091286",
            "telephone_number": "385-279-4334",
            "fax_number": "385-212-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYBREAK PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "385-279-4334"
    },
    "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
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Platinum Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.