LIBERTY MOUNTAIN DENTAL LLC (NPI# 1679182612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679182612 |
| Entity Type | Organization |
| Organization Name | LIBERTY MOUNTAIN DENTAL LLC |
| Practice Address |
6351 W 13400 S Ste 100 Herriman UT 84096-5601 |
| Mailing Address |
1860 N 40 E Orem UT 84057-2235 |
| Practice Telephone | 3852375252 |
| Mailing Telephone | 8014405520 |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2020-07-27 |
| Authorized Official Name | DR. TREVOR ROSS LINDGREN (PRINCIPAL OWNER (CEO)) |
| Authorized Official Telephone | 8014405520 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Copper Mountain Dental | Doing Business As Name - Organization |
| Street Address |
6351 W 13400 S STE 100 |
| City | HERRIMAN |
| State | UT |
| Zip Code | 84096-5601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306499249 | Abundant Dental Care, P.C. | Dentist | 5089 West 12600 South, Herriman, UT 84096 | 2019-07-19 |
| 1225563703 | Kristen Haslam | Specialist/Technologist, Other | 13947 S Newburg Dr., Herriman, UT 84096 | 2017-04-21 |
| 1770960452 | Tyler Rolland Petersen | Social Worker | 13351 S Shaunna Lane, Herriman, UT 84096 | 2015-05-01 |
| 1649687948 | Victor Clark | Assisted Living Facility | 6352 W 13100 S, Herriman, UT 84096 | 2014-07-18 |
| 1548539554 | Neck and Back Relief | Chiropractor | 12600 S. 4013 W., Suite E, Riverton, UT 84096 | 2011-12-20 |
| 1114220092 | Sharlene Christensen | Counselor | 13878 S. Ken Cv, Herriman, UT 84096 | 2010-12-14 |
| 1518156991 | Jon Christian Fairbanks | Dentist | 5532 W. Herriman Main Street, #210, Herriman, UT 84096 | 2007-10-22 |
| 1215154232 | Karen Jane Olson | Nurse Practitioner | 13400 S. 5746 W #200, Herriman, UT 84096 | 2007-04-19 |
| 1619022969 | Jeffrey T Lambert | Dentist | 5532 W. Herriman Main St., #210, Herriman, UT 84096 | 2007-01-25 |
| 1578638854 | Stevenson Pediatric Dentistry P.C. | Dentist | 4019 W. 12600 S., Suite 200, Riverton, UT 84096 | 2006-11-21 |
| Find all providers in zip 84096 | ||||
| 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 |
|---|---|---|---|---|
| 1871888735 | Jed C. Nordfelt | Dentist | 6351 W 13400 S, Herriman, UT 84096-5790 | 2011-06-17 |
| 1346478666 | Chase O Dansie | Dentist | 11996 S Anthem Park Blvd Ste 100, Herriman, UT 84096-5643 | 2009-06-25 |
| 1518156991 | Jon Christian Fairbanks | Dentist | 5532 W. Herriman Main Street, #210, Herriman, UT 84096 | 2007-10-22 |
| 1740409853 | John Walter Day | Dentist | 5514 W 13400 S, Herriman, UT 84065-6919 | 2007-04-25 |
| 1619022969 | Jeffrey T Lambert | Dentist | 5532 W. Herriman Main St., #210, Herriman, UT 84096 | 2007-01-25 |
| 1376656017 | Smilewide Dental Care PC | Dentist | 5629 W. 13100 S., Herriman, UT 84096 | 2006-08-16 |
| 1972516284 | Rodney Jonathan Thornell | Dentist | 5629 W. 13100 S, Herriman, UT 84096 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023625407 | Austin Keith Woodfield | Dentist | 1305 N Commerce Dr # 22, Saratoga Springs, UT 84045-5305 | 2020-09-29 |
| 1750992111 | Jennifer Lin Sorge | Dentist | 532 N Mallard Dr Unit A, Vineyard, UT 84059-6606 | 2020-08-11 |
| 1750991402 | Dr. Alexander B. Larsen Dds | Dentist | 385 W. Center Street, Orem, UT 84057 | 2020-08-07 |
| 1417575879 | Utah Family Dental Cottonwood Heights | Dentist | 7069 S Highland Dr Ste 200, Salt Lake City, UT 84121-3731 | 2020-07-10 |
| 1043838840 | Jordan Sanger | Dentist | 6770 S 900 E Ste 301, Midvale, UT 84047-1761 | 2020-07-08 |
| 1356969307 | Jacob Marlan Haslam | Dentist | 448 E 5350 S Ste C, Ogden, UT 84405-5415 | 2020-07-07 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1376167502 | Ashleigh Dearing | Dentist | 1652 N Blackhawk Dr, Saratoga Springs, UT 84045-5810 | 2020-06-03 |
| 1376167650 | Michael Roberts | Dentist | 7555 S Center View Ct Ste 201, West Jordan, UT 84084-1971 | 2020-06-03 |
| 1962025643 | Cutler Frandsen | Dentist | 75 N 100 E, Gunnison, UT 84634-7720 | 2020-05-28 |
| 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.