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PROVO PEDIATRIC DENTAL
NPI 1184320293
Dentist - Pediatric Dentistry in Provo, UT

Active since February 01, 2023
745 N 500 W, PROVO, UT 84601(801) 373-4200(801) 373-0816 Get Directions Write a Review

NPPES record last updated: February 1, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Provo Pediatric Dental NPPES

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

PROVO PEDIATRIC DENTAL (NPI 1184320293) is a healthcare organization registered as a pediatric dentistry in Provo, Utah and active in the NPI registry since February 2023. The organization maintains a secondary practice location in Price and lists Barbara Mccourt, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1184320293
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePROVO PEDIATRIC DENTAL
Location Address745 N 500 WProvo, UT 84601-1472
Mailing Address391 N 400 EPrice, UT 84501-2537 · (435) 637-9590 · Fax (435) 637-2228
Phone(801) 373-4200
Fax(801) 373-0816
Organization SubpartNo
Authorized OfficialBarbara MccourtOffice Manager · (435) 637-9590
Enumeration DateFebruary 1, 2023
NPPES CertifiedFebruary 1, 2023
✔ NPI 1184320293 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
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.
745 N 500 W, Provo, UT 84601
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Secondary Practice Location 1

Location 1391 N 400 EPrice, UT 84501-2537 · Phone (435) 637-9590 · Fax (435) 637-2228

Other Identifiers 3

Other1811446727UT · Type 1 Npi
Other1912072620UT · Type 1 Npi
Other1598830291UT · Type 1 Npi

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

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROD J. BRIDGE D.D.S.PERIODONTIST
Dentist (Periodontics)
745 N 500 W, SUITE 102
PROVO, UT 84601
Utah County (801) 374-8002
DR. HUGO G ALTAMIRANO M.D.
Specialist
745 N 500 W, #200
PROVO, UT 84601
Utah County (801) 375-9292
DR. EVAN J MATHESON M.D.
Allergy & Immunology
745 N 500 W, #200
PROVO, UT 84601
Utah County (801) 375-9292

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 Provo Pediatric Dental's NPI number?

The NPI number for Provo Pediatric Dental is 1184320293. It was assigned to this organization in the NPPES registry on February 1, 2023.

Where is Provo Pediatric Dental located?

Provo Pediatric Dental is located at 745 N 500 W, Provo, UT 84601. The listed phone number is (801) 373-4200.

What is Provo Pediatric Dental's specialty?

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

When was this NPI record last updated?

The NPPES record for Provo Pediatric Dental was last updated on February 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.