Jeremy B Mahoney DMD LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JEREMY B MAHONEY DMD LLC

Practice address

8846 S Redwood Rd Ste N201
West Jordan, UT 84088-4702

Phone

(801) 566-0631

Fax

(801) 566-4826

NPI assigned

Jun 22, 2021

Organization subpart

No

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

Authorized official

Name

April N Petersen

Title

Practice Manager

Phone

(801) 566-0631

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Copperfield Dental Doing business as

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy Bruce Mahoney, DMD

  • General Practice Dentistry
  • West Jordan, UT
  • NPI 1083069561
  NPD
• Cleo Stephanides Cheney, D.D.S.

  • General Practice Dentistry
  • Oak Park, IL
  • NPI 1821501495
  NPD (past)

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1770152985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8846 S REDWOOD RD STE N201",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884702",
            "telephone_number": "801-566-0631",
            "fax_number": "801-566-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8846 S REDWOOD RD STE N201",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884702",
            "telephone_number": "801-566-0631",
            "fax_number": "801-566-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY B MAHONEY DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "801-566-0631"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE CO",
            "identifier": "1154705960",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "67.182.228.36",
            "affiliation": "N",
            "address_1": "8846 S Redwood Rd Ste N201",
            "city": "West Jordan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840884702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Copperfield Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaily Jensen
• Kevin Scott Jensen, MD
• Porter Jensen
• Michele Suzanne Jenson
• Natalie L Jenson, LCSW
• Jeremy Hewitt DNP LLC
• Peggy Anne Jerome, APRN
• Jillian Jessop, PHARMD
• Yangzi Maggie Jiang, O.D.
• Cynthia Kay Jimenez

• Dental Clinic/Center in West Jordan, UT
• Providers in West Jordan, 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 Jun 22, 2021; 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.