BOUNTIFUL RIDGE DENTAL, LLC
NPI 1508387564
Dentist - General Practice in Bountiful, UT

NPI Status: Active since June 29, 2017

Contact Information

415 MEDICAL DR STE A200
BOUNTIFUL, UT
ZIP 84010
Phone: (801) 203-0290
Fax: (801) 872-4329

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  • Organization
  • Dentist
  • General Practice
  • CLIA Number: 46D0953427
  • CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
  • CLIA Exp. Date: 11-01-2026

About BOUNTIFUL RIDGE DENTAL, LLC

This page provides the complete NPI Profile along with additional information for Bountiful Ridge Dental, Llc, a provider established in Bountiful, Utah operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1508387564 assigned on June 2017. The practitioner's primary taxonomy code is 1223G0001X with license number 8008797 (UT). The provider is registered as an organization and their NPI record was last updated 4 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Mark Spencer Mcgowan Dmd (Owner)

NPI
1508387564
Provider Name
BOUNTIFUL RIDGE DENTAL, LLC
Entity Type
Organization
Location Address
415 MEDICAL DR STE A200 BOUNTIFUL, UT 84010
Location Phone
(801) 203-0290
Location Fax
(801) 872-4329
Mailing Address
415 MEDICAL DR STE A200 BOUNTIFUL, UT 84010
Mailing Phone
(801) 203-0290
Mailing Fax
(801) 872-4329
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-29-2017
Last Update Date
07-21-2022
Code Navigator

A dentist like Bountiful Ridge Dental, Llc 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 General Practice

Taxonomy Code
1223G0001X
Type
Dental Providers
License No.
8008797
License State
UT
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. MARK SPENCER MCGOWAN DMD

Authorized Official Title
OWNER
Authorized Official Phone
(801) 203-0290

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
46D0953427
Facility Type
End Stage Renal Disease Dialysis Facility
Certificate Effective Date
November 02, 2024
Certificate Expiration Date
November 01, 2026
Laboratory Director
ROBERT YENCHEK
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Bountiful Ridge Dental, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1508387564, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
0
Doubled → 0
Pos 4
8
Unchanged
Pos 5
3
Doubled → 6
Pos 6
8
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
5
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 3 → 6 7 → 14 → 5 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 0 + 8 + 6 + 8 + 1 + 4 + 5 + 1 + 2 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1508387564.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508387564, enumerated as an "organization" on June 29, 2017.

The provider is located at 415 MEDICAL DR STE A200 BOUNTIFUL, UT 84010 and the phone number is (801) 203-0290.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.