PDC RIVERTON LLC (NPI# 1306291422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306291422 |
| Entity Type | Organization |
| Organization Name | PDC RIVERTON LLC |
| Other Organization Name | PLATINUM DENTAL CARE |
| Practice Address |
2364 W 12600 S Ste 1a Riverton UT 84065-7109 |
| Mailing Address |
2476 N University Pkwy Ste 201 Provo UT 84604-3869 |
| Practice Telephone | 8012538866 |
| Mailing Telephone | 8013053460 |
| Mailing Fax Number | 8016929083 |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |
| Authorized Official Name | TAELOR JEPPSON (INSURANCE COORDINATOR) |
| Authorized Official Telephone | 8013053460 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Platinum Dental Care | Doing Business As Name - Organization |
| Street Address |
2364 W 12600 S STE 1A |
| City | RIVERTON |
| State | UT |
| Zip Code | 84065-7109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831165224 | David Jay Johnson | Dentist | 2364 W 12600 S, Riverton, UT 84065-7109 | 2006-02-24 |
| 1558578310 | Kevin Llewellyn Yeager | Dentist | 2364 W 12600 S, Suite F, Riverton, UT 84065-7109 | 2007-05-17 |
| 1629001474 | Jodie J Johnson | Optometrist | 2364 W 12600 S, Suite E, Riverton, UT 84065-7109 | 2006-07-07 |
| 1285664359 | First Health Choice | Chiropractor | 2364 W 12600 S, Riverton, UT 84065-7109 | 2006-07-04 |
| 1174569248 | Derek Wayne Birch | Chiropractor | 2364 W 12600 S, Riverton, UT 84065-7109 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972248 | William Lance Andersen | Pharmacist | 1202 W 12600 W, Riverton, UT 84065 | 2020-11-02 |
| 1275172678 | Dentists of Riverton, LLP | Dentist | 4531 W. Partridgehill Lane, Suite F-110, Riverton, UT 84065 | 2020-01-02 |
| 1194201467 | Patrick Kunkel | Dentist | 12569 2700 W, #100, Riverton, UT 84065 | 2018-07-19 |
| 1790274546 | Harmon City Inc | Pharmacy | 13330 South Kestrel Range Road, Riverton, UT 84065 | 2018-05-08 |
| 1386147767 | Richard Hayes Johnston | Counselor | 3740 S Market Center Dr #1200, Riverton, UT 84065 | 2018-03-13 |
| 1023537156 | Brenda Fuell | Dental Hygienist | 12959 South Picket Fence Lane, Riverton, UT 84065 | 2017-09-09 |
| 1407373426 | Bethany Marie Breck | Counselor | 3740 S Market Center Drive, #1200, Riverton, UT 84065 | 2017-08-30 |
| 1952848509 | Renaissance Ranch Bluffdale Women's Program | Substance Abuse Rehabilitation Facility | 2356 Thunderhead Way, Bluffdale, UT 84065 | 2017-01-20 |
| 1053856229 | Bradford Scott Bentley Jr. | Physical Therapist | 3741 W 12600 S, Ste 100, Riverton, UT 84065 | 2016-12-27 |
| 1194273524 | New Horizon | Preferred Provider Organization | 1420 W 12600 Sputh, Draper, UT 84065 | 2016-09-14 |
| Find all providers in zip 84065 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275172678 | Dentists of Riverton, LLP | Dentist | 4531 W. Partridgehill Lane, Suite F-110, Riverton, UT 84065 | 2020-01-02 |
| 1164801619 | Scott Lewis | Dentist | 3409 W 12600 S Ste 100, Riverton, UT 84065-7266 | 2015-05-29 |
| 1962806331 | Moss Dentistry | Dentist | 203 E Main Street, Suite 205, Riverton, WY 82501 | 2014-10-14 |
| 1164869913 | Young Family Dental-riverton | Dentist | 12562 Rhetski Ln, Riverton, UT 84065 | 2013-06-03 |
| 1770860595 | Riverton Smiles | Dentist | 1224 East Jackson Ave, Riverton, WY 82501-3841 | 2011-11-08 |
| 1861728735 | David T Clegg | Dentist | 5069 W 13400 S Ste 200, Riverton, UT 84096-6602 | 2009-10-27 |
| 1265664072 | Stone Creek Family Dental | Dentist | 2332 W 12600 S Ste A, Riverton, UT 84065-7172 | 2009-08-12 |
| 1366632994 | Guy Salisbury Menefee | Dentist | 325 W Main St Ste G, Riverton, WY 82501-3448 | 2007-07-30 |
| 1780884353 | Jeremy L Thompson | Dentist | 1756 West Park Ave, Riverton, UT 84065 | 2007-07-23 |
| 1942406079 | Christopher J Moss | Dentist | 203 E Main St Ste 205, Riverton, WY 82501-4350 | 2007-06-25 |
| Find all providers in RIVERTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.