WASATCH PERIODONTAL SPECIALISTS LLC
NPI 1962162412
Dentist - Periodontics in Salt Lake City, UT

Q: What is Wasatch Periodontal Specialists LLC's NPI number?

The NPI number for Wasatch Periodontal Specialists LLC is 1962162412. It was assigned to this organization in the NPPES registry on December 26, 2021. The provider is doing business as Wasatch Periodontics.

Q: What is Wasatch Periodontal Specialists LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Active since December 26, 2021

4252 S HIGHLAND DR STE 101, SALT LAKE CITY, UT 84124(801) 783-6249 Get Directions Write a Review

NPPES record last updated: December 26, 2021. Verified against the NPPES registry weekly; last sync: September 27, 2026.

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About Wasatch Periodontal Specialists Llc NPPES

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

WASATCH PERIODONTAL SPECIALISTS LLC (NPI 1962162412), doing business as Wasatch Periodontics, is a healthcare organization registered as a periodontics in Salt Lake City, Utah and active in the NPI registry since December 2021. The organization lists Daniel Thunell, Member, as its authorized official.

NPPES Registry Identity

NPI1962162412

Entity TypeOrganization

Primary Taxonomy1223P0300X

Legal Business NameWASATCH PERIODONTAL SPECIALISTS LLC

Location Address4252 S HIGHLAND DR STE 101Salt Lake City, UT 84124-2684

Mailing Address4252 S Highland Dr Ste 101Salt Lake City, UT 84124-2684 · (801) 783-6249

Phone(801) 783-6249

Organization SubpartNo

Authorized OfficialDaniel ThunellMember · (801) 783-6249

Enumeration DateDecember 26, 2021

NPPES CertifiedDecember 26, 2021

✔ NPI 1962162412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

4252 S HIGHLAND DR STE 101, Salt Lake City, UT 84124

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Other Names 1

Doing Business AsWasatch Periodontics

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Wasatch Periodontal Specialists LLC's NPI number?

The NPI number for Wasatch Periodontal Specialists LLC is 1962162412. It was assigned to this organization in the NPPES registry on December 26, 2021. The provider is doing business as Wasatch Periodontics.

Where is Wasatch Periodontal Specialists LLC located?

Wasatch Periodontal Specialists LLC is located at 4252 S Highland Dr Ste 101, Salt Lake City, UT 84124. The listed phone number is (801) 783-6249.

What is Wasatch Periodontal Specialists LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Wasatch Periodontal Specialists LLC was last updated on December 26, 2021. 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.