SOUTHRIDGE DENTISTRY
NPI 1073177648
Clinic/Center - Dental in Riverton, UT
About Southridge Dentistry NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHRIDGE DENTISTRY (NPI 1073177648) is a healthcare organization registered as a dental in Riverton, Utah and active in the NPI registry since April 2019. The organization lists Seth Glickman, Intmn Medical Group Pres/cmo Cbc, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southridge Dentistry is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3,683Medicare enrollment records show 3,683 clinicians reassign Medicare billing to Southridge Dentistry, which bills Medicare for the services they deliver. Of these, 17 practice at this address and 338 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 68
Nearest to this location (20)
See all 3,683Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ihc Health Services Inc's NPI number?
The NPI number for Ihc Health Services Inc is 1073177648. It was assigned to this organization in the NPPES registry on April 29, 2019. The provider is doing business as Southridge Dentistry.
Where is Ihc Health Services Inc located?
Ihc Health Services Inc is located at 3723 W 12600 S Ste 430, Riverton, UT 84065. The listed phone number is (801) 285-4200.
What is Ihc Health Services Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.
Is Ihc Health Services Inc enrolled in Medicare?
Yes. Ihc Health Services Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ihc Health Services Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 3,683 clinicians in 68 Medicare specialties reassign their Medicare billing to Ihc Health Services Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (813), Family Practice (484) and Internal Medicine (246). Of these, 17 practice at this address and 338 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Ihc Health Services Inc was last updated on April 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Southridge Dentistry · NPI 1073177648
Dental organization in Riverton, Utah. Organization record, active in the CMS NPPES registry since April 29, 2019.
## Identity
- **NPI:** 1073177648 (Entity type: Organization)
- **Enumerated:** April 29, 2019
- **Primary specialty:** Clinic/Center - Dental · taxonomy 261QD0000X
- **Legal business name:** Ihc Health Services Inc
- **Organization subpart:** No
- **Authorized official:** Seth Glickman, INTMN MEDICAL GROUP PRES/CMO CBC
## Practice location
- **Address:** 3723 W 12600 S STE 430, Riverton, UT 84065-7310
- **Phone:** (801) 285-4200
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3,683 clinicians in 68 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (813), Family Practice (484), Internal Medicine (246); 17 practice at this address and 338 within 10 miles; [full list](https://npiprofile.com/npi/1073177648/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 29, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1073177648) · Data from the CMS NPPES public registry.