Individual provider Active NPI

Michael Bryce Warner, DMD

  • Dentist
  • West Jordan, UT
National Provider Identifier
1740562123
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
80578469922 Issued in UT
Practice address
5688 W 7800 S Ste 104
West Jordan, UT 84081-5404
Phone
(801) 254-4454
Fax
(801) 757-6116
NPI assigned
Sep 13, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 80578469922 UT Primary

Addresses

Primary practice location

5688 W 7800 S Ste 104
West Jordan, UT 84081-5404

Mailing address

5688 W 7800 S Ste 104
West Jordan, UT 84081-5404
Phone (801) 254-4454

Other practice location 1

12488 Rosecrest Rd
Suite 1B
Herriman, UT 84096
Phone (801) 254-4454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
80578469922UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Abundant Dental Care, P.C. CurrentSince Jan 19, 2025 Accepting new patients
M Warner DMD LLC CurrentSince Jan 19, 2025 Accepting new patients

Locations

12488 S Rosecrest Rd
Ste B1
Herriman, UT 84096
Phone (801) 254-4454

5688 W 7800 S
Ste 104
West Jordan, UT 84081
Phone (801) 254-4454

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.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1740562123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5688 W 7800 S STE 104",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840815404",
            "telephone_number": "801-254-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5688 W 7800 S STE 104",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840815404",
            "telephone_number": "801-254-4454",
            "fax_number": "801-757-6116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12488 Rosecrest Rd",
            "address_2": "Suite 1B",
            "address_purpose": "LOCATION",
            "city": "Herriman",
            "state": "UT",
            "postal_code": "84096",
            "country_code": "US",
            "telephone_number": "801-254-4454",
            "fax_number": "801-757-6116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARNER",
        "first_name": "MICHAEL",
        "middle_name": "BRYCE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-13",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "80578469922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.