Rodney Gardner, D.D.S.

Individual provider Active NPI General Practice Dentistry · Tremonton, UT

NPI 1740306158 · NPPES record last updated Jan 4, 2024

Key facts

NPI
1740306158
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2759879921 (UT)
Practice address
814 E Main St
Tremonton, UT 84337-6733
Phone
(435) 257-3880
Fax
(435) 257-3887
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170601002634 UT Order and Referring Only - Dentist
Practitioner - Dentist
2567739121

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2759879921UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
3G Dental LLC General Practice Current
since Dec 17, 2023
Accepting new patients
3Gdental LLC Current
since Jan 7, 2024
Accepting new patients

Locations

814 E Main St
Tremonton, UT 84337
Phone (435) 230-8030

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2759879921 UT Yes

Addresses

Primary practice location

814 E Main St
Tremonton, UT 84337-6733

Mailing address

814 E Main St
Tremonton, UT 84337-6733
Phone (435) 257-3380

Other providers in Tremonton, UT

All providers in Tremonton, UT · General Practice Dentistry in Utah

Sources for this page

Verify at the official NPI Registry.