SIMPLY DENTAL OF SOUTH JORDAN, LLC (NPI# 1093138448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093138448 |
| Entity Type | Organization |
| Organization Name | SIMPLY DENTAL OF SOUTH JORDAN, LLC |
| Other Organization Name | SOUTH JORDAN DENTAL |
| Practice Address |
1268 W South Jordan Pkwy Suite 302 South Jordan UT 84095-4652 |
| Practice Telephone | 8012533900 |
| Practice Fax Number | 8012533342 |
| Mailing Telephone | 8012533900 |
| Mailing Fax Number | 8012533342 |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |
| Authorized Official Name | MR. MARCUS H WEBB (OWNER/BUSINESS DIRECTOR) |
| Authorized Official Telephone | 8019155947 |
| Is Organization Subpart | Y |
| Parent Organization Name | SIMPLY DENTAL GROUP, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
139125 | UT | Dental Providers |
| Other Name | Type Code |
|---|---|
| South Jordan Dental | Doing Business As Name - Organization |
| Street Address |
1268 W SOUTH JORDAN PKWY SUITE 302 |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095-4652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538182373 | Troy Steven Thomson | Dentist | 1268 W South Jordan Pkwy, Suite #102, South Jordan, UT 84095-4652 | 2006-07-25 |
| 1457894651 | Families First Pediatrics | Clinic/Center | 1268 W South Jordan Pkwy, 201, South Jordan, UT 84095-4652 | 2016-11-21 |
| 1437530334 | Joshua Sharp | Dentist | 1268 W South Jordan Pkwy, Suite 302, South Jordan, UT 84095-4652 | 2015-06-16 |
| 1013324508 | Jennifer Ashton | Nurse Practitioner | 1268 W South Jordan Pkwy, South Jordan, UT 84095-4652 | 2014-07-16 |
| 1215213905 | David M. S. Stewart Dds PC | Dentist | 1268 W South Jordan Pkwy, Suite 101, South Jordan, UT 84095-4652 | 2011-10-26 |
| 1073804001 | Thayne Henrie Gardner | Dentist | 1268 W South Jordan Pkwy, Suite 101, South Jordan, UT 84095-4652 | 2011-04-25 |
| 1669662425 | Kyle S Christensen, Dds, PC | Dentist | 1268 W South Jordan Pkwy, Suite 200, South Jordan, UT 84095-4652 | 2007-07-27 |
| 1194863589 | Families First Pediatrics LLC | Pediatrics | 1268 W South Jordan Pkwy, Ste.#201, South Jordan, UT 84095-4652 | 2007-02-01 |
| 1396839403 | Michael Ray Johnson | Pediatrics | 1268 W South Jordan Pkwy, Ste 201, South Jordan, UT 84095-4652 | 2006-10-03 |
| 1811081904 | Matthew Nelson Cox | Pediatrics | 1268 W South Jordan Pkwy, Ste 201, South Jordan, UT 84095-4652 | 2006-10-03 |
| Find all providers in the same location | ||||
| 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 | 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 |
|---|---|---|---|---|
| 1700409695 | Wasatch Dental Group LLC | Dentist | 1685 W Towne Center Dr, South Jordan, UT 84095-8697 | 2020-05-26 |
| 1760022768 | Sojo Dental | Dentist | 3473 W South Jordan Parkway, Ste. 2, South Jordan, UT 84095-6016 | 2020-01-08 |
| 1730745456 | Michael Thomas | Dentist | 4775 W Daybreak Pkwy Ste 201, South Jordan, UT 84009-5140 | 2019-05-17 |
| 1710479795 | Lee Hoang Mai | Dentist | 3672 W South Jordan Pkwy Ste 104, South Jordan, UT 84009-7172 | 2018-06-05 |
| 1902321045 | Clark Dental P.C. | Dentist | 10597 S Beach Comber Way, South Jordan, UT 84009-6132 | 2017-08-10 |
| 1063949782 | Joby Chaluparambil | Dentist | 11758 S District Dr, Unit 702, South Jordan, UT 84095-6041 | 2017-05-11 |
| 1871978981 | Jacob Boyack | Dentist | 2651 W South Jordan Pkwy Ste 203, South Jordan, UT 84095-8968 | 2015-07-30 |
| 1427452614 | Genesis Dental of Riverton | Dentist | 11428 South Parkway Plaza Drive, Suite 400, South Jordan, UT 84095 | 2014-10-16 |
| 1336573120 | James R Donahoo | Dentist | 10894 S. River Front Parkway, South Jordan, UT 84095 | 2013-08-28 |
| 1881953966 | David Densley | Dentist | Roseman University, 10920 S River Front Pkwy, South Jordan, UT 84095 | 2012-05-10 |
| 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.