DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MODERN DENTAL PROFESSIONALS UTAH, PC

Deactivated Organization

General Dentistry · SANDY, UT

This NPI has been deactivated. The record was deactivated on April 8, 2024. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1487913869
Provider Type
Organization
NPI Issued
May 7, 2012 (11.920765027322 yrs)
Last Updated
Mar 27, 2025
Deactivated
Apr 8, 2024

Practice Information

Address
10011 S CENTENNIAL PKWY STE 330
SANDY, UT, 840704178
Browse UT providers · Browse ZIP 84070
Phone
8012563700
Fax
8015761777
Primary Specialty
General Dentistry
1223G0001X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.