SOUTH JORDAN PDC PLLC
NPI 1336706043
Dentist in South Jordan, UT
NPI Status: Active since May 29, 2019
Contact Information
10458 S REDWOOD RD
SOUTH JORDAN, UT
ZIP 84095
Phone: (801) 302-8989
- Organization
- Dentist
- Accepts Insurance
- CLIA Number: 46D2010490
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-28-2026
About SOUTH JORDAN PDC PLLC
This page provides the complete NPI Profile along with additional information for South Jordan Pdc Pllc, a provider established in South Jordan, Utah operating as a Dentist. The healthcare provider is registered in the NPI registry with number 1336706043 assigned on May 2019. The practitioner's primary taxonomy code is 122300000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. South Jordan Pdc Pllc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. Juan Carlos Chavez Dmd (Owner)
- NPI
- 1336706043
- Provider Name
- SOUTH JORDAN PDC PLLC
- Entity Type
- Organization
- Location Address
- 10458 S REDWOOD RD SOUTH JORDAN, UT 84095
- Location Phone
- (801) 302-8989
- Mailing Address
- PO BOX 970113 OREM, UT 84097
- Mailing Phone
- (801) 305-3460
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-29-2019
- Last Update Date
- 05-29-2019
- Code Navigator
A dentist like South Jordan Pdc Pllc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist
- Taxonomy Code
- 122300000X
- Type
- Dental Providers
- Taxonomy Description
- A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1223P0300X | Dental Providers | Dentist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Smile Now Arizona - No Waiting Period PPO - PPO
- Smile Now Illinois - No Waiting Period PPO - PPO
- Smile Now Michigan - No Waiting Period PPO - PPO
- Smile Now Ohio - No Waiting Period PPO - PPO
- Smile Now Tennessee - No Waiting Period PPO - PPO
- Smile Now Texas- No Waiting Period Plan - PPO
- Smile Now Utah - No Waiting Period PPO - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 46D2010490
- Facility Type
- Physician Office
- Certificate Effective Date
- July 29, 2024
- Certificate Expiration Date
- July 28, 2026
- Laboratory Director
- DAVID OWEN
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to South Jordan Pdc Pllc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 3 | 6 | 7 | 0 | 6 | 0 | 4 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 6 | 6 | 14 | 0 | 12 | 0 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 6 + 6 + 1 + 4 + 0 + 1 + 2 + 0 + 8 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1336706043 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
PETERSEN DENTAL LLC
Dentist
10458 S REDWOOD RD
SOUTH JORDAN, UT
ZIP 84095
RYAN HUNTER DDS
Dentist
(General Practice)
10458 S REDWOOD RD
SOUTH JORDAN, UT
ZIP 84095
DR. KEVIN STAPLETON DDS
Dentist
10458 S REDWOOD RD
SOUTH JORDAN, UT
ZIP 84095
RYAN GLEN FRANDSEN RDH
Dental Hygienist
10458 S REDWOOD RD
SOUTH JORDAN, UT
ZIP 84095
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336706043, enumerated as an "organization" on May 29, 2019.
The provider is located at 10458 S REDWOOD RD SOUTH JORDAN, UT 84095 and the phone number is (801) 302-8989.
Dentist with taxonomy code 122300000X.
The provider might be accepting Accepts: UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.
