CLUBHOUSE PEDIATRIC DENTISTRY OF WEST JORDAN is a pediatric dentistry dentist in Midvale, UT. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. CLUBHOUSE PEDIATRIC DENTISTRY OF WEST JORDAN NPI is 1639654684. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
1108 E SOUTH UNION AVE MIDVALE, UT ZIP 84047-904 Phone: (208) 520-1514
The provider's authorized official is Jennifer Louise Robison . The authorized official title is Credentialing Coordinator and has the following contact phone number (208) 520-1514.
The enumeration date for this NPI number is 9/26/2018 and was last updated on 9/26/2018.
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.
This page was last updated on: 3/30/2025
NPI Synchronization or Removal
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