DR. ROD J. BRIDGE (NPI# 1174741227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174741227 |
Entity Type | Individual |
Full Name | DR. ROD J. BRIDGE |
Credential | D.D.S.PERIODONTIST |
Practice Address |
745 N 500 W Suite 102 Provo UT 84601-1472 |
Practice Telephone | 8013748002 |
Practice Fax Number | 8013710393 |
Mailing Telephone | 8013748002 |
Mailing Fax Number | 8013710393 |
Enumeration Date | 2007-04-23 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
22150 | UT | Dental Providers |
Street Address |
745 N 500 W SUITE 102 |
City | PROVO |
State | UT |
Zip Code | 84601-1472 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417938325 | Hugo G Altamirano | Specialist | 745 N 500 W, #200, Provo, UT 84601-1472 | 2005-11-08 |
1649251646 | Evan J Matheson | Specialist | 745 N 500 W, #200, Provo, UT 84601-1472 | 2005-11-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
Find all providers in zip 84601 |
Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467636688 | Ryan K Edmunds | Dentist | 745 N 500 W Ste 102, Provo, UT 84601-1473 | 2007-12-24 |
1457568891 | Craig Martin Ririe | Dentist | 3610 N. University Ave., 150, Provo, UT 84604 | 2007-05-16 |
1285740407 | George M Bailey | Dentist | 3585 N University Ave Ste 200, 200, Provo, UT 84604-6631 | 2006-08-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
1225673429 | Mountain View Dental Pdc Pllc | Dentist | 6783 S Redwood Rd #201, South Jordan, UT 84084-5743 | 2019-11-12 |
1699317685 | Daybreak Pdc Pllc | Dentist | 4040 West Daybreak Pkwy, Suite 103, South Jordan, UT 84009-1286 | 2019-10-11 |
1649837337 | North Logan Pdc Pllc | Dentist | 1445 N 400 E Ste 3a, Logan, UT 84341-7564 | 2019-05-29 |
1154701993 | Robert David Swenson | Dentist | 3397 N 1200 E Ste 111, Lehi, UT 84043 | 2015-06-07 |
1710385000 | C & F Implants LLC | Dentist | 347 N 300 W, Suite 201, Kaysville, UT 84037-1828 | 2014-12-18 |
1548668353 | C & F Implants LLC | Dentist | 5331 Adams Ave Pkwy Ste A, South Ogden, UT 84405-4755 | 2014-12-10 |
1457797185 | Rachana Ashok Hegde | Dentist | 10920 S River Front Parkway, College of Dental Medicine Roseman University of Health, South Jordan, UT 84095 | 2013-05-21 |
1265788210 | Mitchell Miles Gubler | Dentist | 368 E Riverside Dr Ste 7, St George, UT 84790-7278 | 2012-07-27 |
1881982585 | Lloyd V Tilt | Dentist | 1316 Harvard Ave, Salt Lake City, UT 84105-1916 | 2011-07-14 |
Find all providers with the same taxonomy |
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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.