PEDIATRIC DENTAL PC (NPI# 1992880710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992880710 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL PC |
| Practice Address |
1401 N Highway 89 #200 Farmington UT 84025-2745 |
| Practice Telephone | 8014475437 |
| Practice Fax Number | 8014474685 |
| Mailing Telephone | 8014475437 |
| Mailing Fax Number | 8014474685 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOHN R. ANDERSON (OWNER) |
| Authorized Official Telephone | 8015405081 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
341292 | UT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 528537398004 | 05 |
| Street Address |
1401 N HIGHWAY 89 #200 |
| City | FARMINGTON |
| State | UT |
| Zip Code | 84025-2745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407822000 | John R Anderson | Dentist | 1401 N Highway 89, #200, Farmington, UT 84025-2745 | 2006-02-24 |
| 1760443154 | Sally S Tan | Family Medicine | 1401 N Highway 89, Suite 220, Farmington, UT 84025-2745 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013522200 | Kim Nguyen | Behavior Technician | 1148 N Wilow Wind Rd Unit 9, Farmington, UT 84025 | 2020-09-14 |
| 1164980181 | Adam Thomas Creer | Nurse Practitioner | 696 N 40 E Apt 2, Farmington, UT 84025 | 2019-03-08 |
| 1881100550 | Lindsay Case | Counselor | 1645 W 1440 N, Farmington, UT 84025 | 2017-12-18 |
| 1447707955 | Joseph Daniel Levie | Chiropractor | 63 N. Main Street, Farmington, UT 84025 | 2016-09-01 |
| 1649724139 | University of Utah Adult Services | Dermatology | 165 N. University Ave. Farmington, Farmington, UT 84025 | 2016-08-12 |
| 1679931075 | Rhodes Physical Therapy, Inc | Clinic/Center | 722 W. Shepard Lane Suite 105, Farmington, UT 84025 | 2016-02-01 |
| 1760847552 | Polished Holdings, Inc. | Specialist | 491 W. Bourne Circle, Suite 2, Farmington, UT 84025 | 2015-12-21 |
| 1568833911 | Ageless Men's Health Holdings, LLC | Specialist | 491 West Bourne Circle, Suite 2, Farmington, UT 84025 | 2015-10-12 |
| 1588053300 | Onsyte Surgical of Nevada, LLC | Clinic/Center | 1262 S 650 W Suite 1d, Farmington, UT 84025 | 2015-01-16 |
| 1568879872 | Laura Cook | Counselor | 1200 West Red Barn Lane, Farmington, UT 84025 | 2014-07-18 |
| Find all providers in zip 84025 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104277482 | Ncdi - Animas Professional, LLP | Dentist | 2650 E Pinon Frontage Rd, Bldg #200, Farmington, NM 87402-5084 | 2016-06-28 |
| 1750736377 | Mountain View Pediatric Dentistry of Farmington | Dentist | 991 Shepard Lane, Ste 100, Farmington, UT 84025-2702 | 2016-05-02 |
| 1295823177 | Animas Pediatric Dental Group | Dentist | 2650 E Pinon Frontage Rd. Bldg. 200, Farmington, NM 87402-5061 | 2006-10-10 |
| 1477515104 | Kenneth R Dunston | Dentist | 2050 N Butler Ave, Farmington, NM 87401-4201 | 2006-04-06 |
| 1760443998 | Lawrence Eric Suazo | Dentist | 2650 E. Pinon Frontage Rd. Bldg. 200, Farmington, NM 87402-5061 | 2006-03-29 |
| 1841250529 | Doug Earl Holmes | Dentist | 2650 E. Pinon Frontage Rd., Bldg #200, Farmington, NM 87402-5061 | 2006-03-25 |
| 1407822000 | John R Anderson | Dentist | 1401 N Highway 89, #200, Farmington, UT 84025-2745 | 2006-02-24 |
| 1659756161 | Rawan Sarsour | Dentist | 263 Farmington Ave, Farmington, CT 06030-0001 | 2015-07-26 |
| 1013395359 | Bahar Houshmand | Dentist | 263 Farmington Ave, Farmington, CT 06030-0001 | 2015-05-06 |
| 1518350479 | Katherine Fleming | Dentist | 263 Farmington Ave, Farmington, CT 06032-1956 | 2015-03-16 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 84025 |
Please comment or provide details below to improve the information on PEDIATRIC DENTAL PC.
| 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.