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WEST JORDAN MODERN DENTISTRY AND ORTHODONTICS
NPI 1508134412
Dentist - General Practice in West Jordan, UT

Active since December 06, 2011CLIA 46D2335285 · Waiver
7632 CAMPUS VIEW DR STE 150, WEST JORDAN, UT 84084(801) 282-4142(801) 282-4146 Get Directions Write a Review

NPPES record last updated: April 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About West Jordan Modern Dentistry And Orthodontics NPPES

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

WEST JORDAN MODERN DENTISTRY AND ORTHODONTICS (NPI 1508134412) is a healthcare organization registered as a general practice in West Jordan, Utah and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through December 8, 2027 and lists Christine B. Goodell, Owner, as its authorized official.

NPPES Registry Identity

NPI1508134412
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameWEST JORDAN MODERN DENTISTRY , LLP
Location Address7632 CAMPUS VIEW DR STE 150West Jordan, UT 84084-5630
Mailing AddressPo Box 920050Dallas, TX 75392-0050 · (714) 845-8890 · Fax (949) 474-1495
Phone(801) 282-4142
Fax(801) 282-4146
Organization SubpartNo
Authorized OfficialChristine B. GoodellOwner · (801) 282-4142
Enumeration DateDecember 6, 2011
Last NPPES UpdateApril 13, 2022
NPPES CertifiedApril 13, 2022
✔ NPI 1508134412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
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.
7632 CAMPUS VIEW DR STE 150, West Jordan, UT 84084
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Other Names 1

Doing Business AsWest Jordan Modern Dentistry And Orthodontics

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2335285

West Jordan Modern Dentistry And Orthodontics · West Jordan, UT
Active · expires Dec 8, 2027
CLIA Number46D2335285
Laboratory TypePractitioner Other
Certificate Effective DateDecember 9, 2025
Certificate Expiration DateDecember 8, 2027
Laboratory DirectorBrendon Tingey
Laboratory Phone(801) 282-4142
Laboratory LocationWest Jordan Modern Dentistry And Orthodontics7632 Campus View Dr, Ste 150, West Jordan, UT 84084
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

DR. MICHAEL MERU DDS
Dentist (Orthodontics and Dentofacial Orthopedics)
7632 CAMPUS VIEW DR STE 150
WEST JORDAN, UT 84084
Salt Lake County (801) 282-4142

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 West Jordan Modern Dentistry , LLP's NPI number?

The NPI number for West Jordan Modern Dentistry , LLP is 1508134412. It was assigned to this organization in the NPPES registry on December 6, 2011. The provider is doing business as West Jordan Modern Dentistry And Orthodontics.

Where is West Jordan Modern Dentistry , LLP located?

West Jordan Modern Dentistry , LLP is located at 7632 Campus View Dr Ste 150, West Jordan, UT 84084. The listed phone number is (801) 282-4142.

What is West Jordan Modern Dentistry , LLP's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Does West Jordan Modern Dentistry , LLP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2335285) is associated with this NPI, valid through December 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for West Jordan Modern Dentistry , LLP was last updated on April 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.