Predentive Dental Company

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5096414 Issued in UT

Legal business name

PREDENTIVE DENTAL COMPANY

Practice address

6957 S 1300 E
Cottonwood Heights, UT 84047-1817

Phone

(801) 618-0246

NPI assigned

Jun 24, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jeff Scott Burg, DDS, MBA

Title

Dentist-Owner

Phone

(801) 618-0246

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1922480144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6957 S 1300 E",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "840471817",
            "telephone_number": "801-618-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6957 S 1300 E",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "840471817",
            "telephone_number": "801-618-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREDENTIVE DENTAL COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-24",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "BURG",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "DENTIST-OWNER",
        "authorized_official_telephone_number": "801-618-0246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MBA"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "UT",
            "license": "5096414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alek Ponce
• Ifan Cassandra Poulsen
• Bradley James Powell, DPT
• Danielle Lauren Powers, MSW, LCSW
• Kelsie Prall
• Angela Provin
• Loren Psalidas, RDN
• Andrea Puchar
• Eugenia A Puche Diaz
• Claire Pugmire, PT, DPT

• Dental Clinic/Center in Cottonwood Heights, UT
• Providers in Cottonwood Heights, 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 Aug 18, 2016; 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.