PETERSEN DENTAL LLC (NPI# 1417315656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417315656 |
Entity Type | Organization |
Organization Name | PETERSEN DENTAL LLC |
Practice Address |
10458 S Redwood Rd South Jordan UT 84095-8501 |
Practice Telephone | 8013028989 |
Practice Fax Number | 8013028989 |
Mailing Telephone | 8013028989 |
Mailing Fax Number | 8013028989 |
Enumeration Date | 2016-02-02 |
Last Update Date | 2016-02-02 |
Authorized Official Name | LUKE PETERSEN (OWNER) |
Authorized Official Telephone | 8013028989 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 122300000X | Dentist | 7702761-99021 | UT | Dental Providers |
Street Address |
10458 S REDWOOD RD |
City | SOUTH JORDAN |
State | UT |
Zip Code | 84095-8501 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538774492 | Ryan Hunter | Dentist | 10458 S Redwood Rd, South Jordan, UT 84095-8501 | 2020-09-08 |
1336706043 | South Jordan Pdc Pllc | Dentist | 10458 S Redwood Rd, South Jordan, UT 84095-8501 | 2019-05-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
Find all providers in zip 84095 |
Taxonomy Code | 122300000X |
Grouping | Dental Providers |
Classification | Dentist |
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518457118 | Christopher L Jacobsen | Dentist | 3473 W S Jordan Pkwy Ste 2, South Jordan, UT 84095-6016 | 2018-05-18 |
1831630763 | Tina Patel | Dentist | 11501 S 4000 W Ste 101, South Jordan, UT 84009 | 2017-03-10 |
1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
1134564388 | Daniel Jed Snedaker | Dentist | 11535 S Jordan Bend Rd, South Jordan, UT 84095-8066 | 2013-05-01 |
1972816288 | Michael R Cottam | Dentist | 4775 W Daybreak Pkwy, Suite 103, South Jordan, UT 84095-5968 | 2010-07-16 |
1881881134 | J. Michael Dunn | Dentist | 11659 S Redwood Rd, South Jordan, UT 84095-7808 | 2007-10-01 |
1225249683 | Southridge Pediatric Dentistry | Dentist | 2651 W. 10400 S. #103, South Jordan, UT 84095 | 2007-05-25 |
1245317759 | Matthew Mcinnes | Dentist | 3556 W 9800 S Ste 102, South Jordan, UT 84095-3225 | 2006-11-01 |
1912090804 | Stuart Lindsay | Dentist | 3672 W South Jordan Pkwy, Suite D104, South Jordan, UT 84095-7171 | 2006-10-02 |
1073622817 | John Shea Bess | Dentist | 3556 West 9800 South, Ste 102, South Jordan, UT 84095 | 2006-08-29 |
Find all providers in SOUTH JORDAN |
City | SOUTH JORDAN |
Zip Code | 84095 |
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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.