Heber PDC PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

HEBER PDC PLLC

Doing business as

Back of the Wasatch

Practice address

321 W 1300 S Ste 230
Heber City, UT 84032-3145

Phone

(435) 201-8843

NPI assigned

Feb 14, 2023

Organization subpart

No

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

Authorized official

Name

Kayla Shade

Title

Revenue Cycle Manager

Phone

(801) 305-3460

Specialties & licenses 1

Addresses

Other names 1

• Back of the Wasatch Doing business as

Locations

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1932806528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W 1300 S STE 230",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W 1300 S STE 230",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323145",
            "telephone_number": "435-201-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEBER PDC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A",
        "authorized_official_last_name": "SHADE",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "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": "Back of the Wasatch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Darrell Hatch, D.C.
• Robert J Hauger, M.D.
• Jesse Hawkes, M.D.
• Heber City Dental
• Heber Opco LLC
• Heber Valley Chiropractic LLC
• Heber Valley Dermatology
• Heber Valley Internal Medicine
• Heber Valley Medical LLC
• Heber Valley Oral & Maxillofacial Surgery

• Dental Clinic/Center in Heber City, UT
• Providers in Heber City, 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 14, 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.