Utah Mountain Dental Partners PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

UTAH MOUNTAIN DENTAL PARTNERS PC

Practice address

321 N Mall Dr Ste D101
St George, UT 84790-7321

Phone

(435) 628-5496

NPI assigned

May 21, 2024

Organization subpart

Yes

Parent organization

SIGNATURE DENTAL PARTNERS LLCAs reported in NPPES

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

Authorized official

Name

Melody Bennion

Title

Director of Integrations

Phone

(480) 234-8490

Specialties & licenses 1

Addresses

Other names 1

• Red Cliffs Dental Implant Center Doing business as

Part of

Signature Dental Partners LLC

Locations

Practitioners 1

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

• Kelly J. Olsen, D.D.S.

  • General Practice Dentistry
  • St George, UT
  • NPI 1407902950
  NPD (past)

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1932948825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N MALL DR STE D101",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907321",
            "telephone_number": "435-628-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N MALL DR STE D101",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907321",
            "telephone_number": "435-628-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH MOUNTAIN DENTAL PARTNERS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SIGNATURE DENTAL PARTNERS LLC",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "BENNION",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "DIRECTOR OF INTEGRATIONS",
        "authorized_official_telephone_number": "480-234-8490"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Cliffs Dental Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in St George, UT
• Providers in St George, 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 May 21, 2024; 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.