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DENTISTS OF SOUTH JORDAN, LLP
NPI 1700391828
Dentist - General Practice in South Jordan, UT

Active since December 12, 2017CLIA 46D2335288 · Waiver
11501 S 4000 W STE 101, SOUTH JORDAN, UT 84009(801) 701-2120 Get Directions Write a Review

NPPES record last updated: December 12, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dentists Of South Jordan, Llp NPPES

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

DENTISTS OF SOUTH JORDAN, LLP (NPI 1700391828) is a healthcare organization registered as a general practice in South Jordan, Utah and active in the NPI registry since December 2017. The organization holds a CLIA Waiver certificate valid through December 8, 2027 and lists Adam Burr, Owner, as its authorized official.

NPPES Registry Identity

NPI1700391828
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameDENTISTS OF SOUTH JORDAN, LLP
Location Address11501 S 4000 W STE 101South Jordan, UT 84009-6028
Mailing Address17000 Red Hill AveIrvine, CA 92614-5626
Phone(801) 701-2120
Organization SubpartNo
Authorized OfficialAdam BurrOwner · (801) 701-2120
Enumeration DateDecember 12, 2017
✔ NPI 1700391828 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.
11501 S 4000 W STE 101, South Jordan, UT 84009
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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 46D2335288

Dentists Of South Jordan And Orthodontics · South Jordan, UT
Active · expires Dec 8, 2027
CLIA Number46D2335288
Laboratory TypePractitioner Other
Certificate Effective DateDecember 9, 2025
Certificate Expiration DateDecember 8, 2027
Laboratory DirectorRyan J. Mcaffee
Laboratory Phone(801) 701-2120
Laboratory LocationDentists Of South Jordan And Orthodontics11501 S 4000 W, Ste 101, South Jordan, UT 84009
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 5

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

VANESSA BIKHAZI DDS
Dentist (Periodontics)
11501 S 4000 W STE 101
SOUTH JORDAN, UT 84009
Salt Lake County (801) 701-2120
DR. ALEXANDER HARRIS DDS
Dentist (General Practice)
11501 S 4000 W STE 101
SOUTH JORDAN, UT 84009
Salt Lake County (801) 701-2120
DR. BRENDON THUESON TINGEY DMD
Dentist
11501 S 4000 W STE 101
SOUTH JORDAN, UT 84009
Salt Lake County (801) 701-2120
TINA PATEL
Dentist
11501 S 4000 W STE 101
SOUTH JORDAN, UT 84009
Salt Lake County (017) 012-1208
DEREK BURGOYNE DMD
Dentist
11501 S 4000 W STE 101
SOUTH JORDAN, UT 84009
Salt Lake County (801) 701-2120

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 Dentists Of South Jordan, LLP's NPI number?

The NPI number for Dentists Of South Jordan, LLP is 1700391828. It was assigned to this organization in the NPPES registry on December 12, 2017.

Where is Dentists Of South Jordan, LLP located?

Dentists Of South Jordan, LLP is located at 11501 S 4000 W Ste 101, South Jordan, UT 84009. The listed phone number is (801) 701-2120.

What is Dentists Of South Jordan, LLP's specialty?

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

Does Dentists Of South Jordan, LLP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2335288) 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 Dentists Of South Jordan, LLP was last updated on December 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.