SOUTH PROVO PDC PLLC
NPI 1538946207
Clinic/Center - Dental in Provo, UT

Q: What is South Provo Pdc PLLC's NPI number?

The NPI number for South Provo Pdc PLLC is 1538946207. It was assigned to this organization in the NPPES registry on September 14, 2023.

Q: What is South Provo Pdc PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

Active since September 14, 2023

2211 E VALLEY VISTA WAY, PROVO, UT 84606(385) 412-6964(385) 248-5034 Get Directions Write a Review

NPPES record last updated: November 8, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About South Provo Pdc Pllc NPPES

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

SOUTH PROVO PDC PLLC (NPI 1538946207) is a healthcare organization registered as a dental in Provo, Utah and active in the NPI registry since September 2023. The organization lists Vivian Betancourt, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1538946207

Entity TypeOrganization

Primary Taxonomy261QD0000X

Legal Business NameSOUTH PROVO PDC PLLC

Location Address2211 E VALLEY VISTA WAYProvo, UT 84606-5636

Mailing AddressPo Box 970185Orem, UT 84097-0185 · (801) 691-1701 · Fax (801) 355-6551

Phone(385) 412-6964

Fax(385) 248-5034

Organization SubpartNo

Authorized OfficialVivian BetancourtCredentialing Specialist · (801) 305-3465

Enumeration DateSeptember 14, 2023

Last NPPES UpdateNovember 8, 2023

NPPES CertifiedNovember 8, 2023

✔ NPI 1538946207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities

Taxonomy Code261QD0000X

2211 E VALLEY VISTA WAY, Provo, UT 84606

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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 Provo Pdc PLLC's NPI number?

The NPI number for South Provo Pdc PLLC is 1538946207. It was assigned to this organization in the NPPES registry on September 14, 2023.

Where is South Provo Pdc PLLC located?

South Provo Pdc PLLC is located at 2211 E Valley Vista Way, Provo, UT 84606. The listed phone number is (385) 412-6964.

What is South Provo Pdc PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for South Provo Pdc PLLC was last updated on November 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.