PETERSEN DENTAL LLC


Address: 10458 S Redwood Rd, South Jordan, UT 84095-8501
Phone: 8013028989

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 122300000X Dentist 7702761-99021 UT Dental Providers

Office Location

Street Address 10458 S REDWOOD RD
City SOUTH JORDAN
State UT
Zip Code 84095-8501

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Competitor

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City SOUTH JORDAN
Zip Code 84095

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Dataset Information

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.

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