Redwood Dental PDC PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

REDWOOD DENTAL PDC PLLC

Practice address

271 N Spring Creek Pkwy Ste D
Providence, UT 84332-9875

Phone

(435) 755-6562

Fax

(435) 755-6797

NPI assigned

Sep 19, 2022

Last updated

Feb 16, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alicia Larsen

Title

Revenue Cycle Management

Phone

(801) 305-3460

Specialties & licenses 1

Addresses

Other names 1

• Redwood Dental LLC Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard S Johnson, DDS

  • General Practice Dentistry
  • Providence, UT
  • NPI 1023024064
  NPD (past)
• Troy R Walton, D.D.S.

  • General Practice Dentistry
  • Providence, UT
  • NPI 1407863574
  NPD (past)

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676505600000",
    "number": "1881317535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970652",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840970652",
            "telephone_number": "435-755-6562",
            "fax_number": "435-755-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 N SPRING CREEK PKWY STE D",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329875",
            "telephone_number": "435-755-6562",
            "fax_number": "435-755-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD DENTAL PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-19",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "801-305-3460"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redwood Dental LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Redwood Dental LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Lauren Marie Stowers Rasmussen, RDN
• Amy Melinda Rathbone, RBT
• Natasha Kate Rawlins, RBT
• Reactive Physical Therapy PLLC
• Redwood Dental
• Brandon Reed, DPT
• Emily J. Rhodes
• Richard T Stevens, MD, PC
• Hannah Rose Riser Smith, RBT
• Ashlynn Robinson, RBT

• Dental Clinic/Center in Providence, UT
• Providers in Providence, 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 Feb 16, 2023; 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.