Jordan Landing Pediatrics

LBN: Jordan Landing Pediatrics
Jordan Landing Pediatrics is an health care organization with primary practice located at 7613 Jordan Landing Blvd Ste 210, West Jordan UT 84084-1972. The organization recently has only one registered license in Dental Providers / Periodontics, which is considered as the primary health care specialty. Jordan Landing Pediatrics can be contacted via phone (801) 280-9595, or through Johansen, R Ryan via phone (801) 280-9595.

Contact Information

Primary practice address
7613 Jordan Landing Blvd Ste 210 West Jordan UT 84084-1972
Phone: (801) 280-9595
Fax: (801) 280-1169
Website:
Map and Directions
Authorized official contact:
Name: Johansen, R Ryan Doctor of Dental Surgery (DDS)
Phone: (801) 280-9595

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X

Profile Details

NPI number 1528374337
LBN Legal business name Jordan Landing Pediatrics
DBA Doing business as
Authorized official Johansen, R Ryan Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 31st, 2010
Last updated Aug 31st, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528374337 NPPES
Nevada MEDICAID 002204002
Nevada MEDICAID 528451522009

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