SOUTH OGDEN PEDIATRIC DENTAL P.C.
NPI 1104834191
Dentist - Pediatric Dentistry in Washington Terrace, UT

Q: What is South Ogden Pediatric Dental P.C.'s NPI number?

The NPI number for South Ogden Pediatric Dental P.C. is 1104834191. It was assigned to this organization in the NPPES registry on August 4, 2006.

Q: What is South Ogden Pediatric Dental P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Active since August 04, 2006

5275 S. ADAMS AVE.,, SUITE C, WASHINGTON TERRACE, UT 84405(801) 475-6433(801) 334-8411 Get Directions Write a Review

NPPES record last updated: June 21, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About South Ogden Pediatric Dental P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH OGDEN PEDIATRIC DENTAL P.C. (NPI 1104834191) is a healthcare organization registered as a pediatric dentistry in Washington Terrace, Utah and active in the NPI registry since August 2006. The organization lists M. Wade Rallison, Owner, as its authorized official.

NPPES Registry Identity

NPI1104834191

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameSOUTH OGDEN PEDIATRIC DENTAL P.C.

Location Address5275 S. ADAMS AVE.,, SUITE CWashington Terrace, UT 84405

Mailing Address5275 S. Adams Ave.,, Suite C Suite #4Washington Terrace, UT 84405 · (801) 475-6433 · Fax (801) 334-8411

Phone(801) 475-6433

Fax(801) 334-8411

Organization SubpartNo

Authorized OfficialM. Wade RallisonOwner · (801) 475-6433

Enumeration DateAugust 4, 2006

Last NPPES UpdateJune 21, 2011

✔ NPI 1104834191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

License✔ Licensed in UT · 5118697-9923

Definition

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.

5275 S. ADAMS AVE.,, Washington Terrace, UT 84405

Open in Google Maps ↗

Other Identifiers 1

Medicaid518155919002UT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health, UnitedHealthcare.Insurance ›

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 South Ogden Pediatric Dental P.C.'s NPI number?

The NPI number for South Ogden Pediatric Dental P.C. is 1104834191. It was assigned to this organization in the NPPES registry on August 4, 2006.

Where is South Ogden Pediatric Dental P.C. located?

South Ogden Pediatric Dental P.C. is located at 5275 S. Adams Ave., Suite C, Washington Terrace, UT 84405. The listed phone number is (801) 475-6433.

What is South Ogden Pediatric Dental P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does South Ogden Pediatric Dental P.C. accept?

Health plans from Select Health and UnitedHealthcare list South Ogden Pediatric Dental P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for South Ogden Pediatric Dental P.C. was last updated on June 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.