WHITE DOME PEDIATRIC DENTAL LLC NPI 1780480665

NPI Information

  • NPI: 1780480665
  • Provider Name: WHITE DOME PEDIATRIC DENTAL LLC
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Address: 6025 S. RIVER RD. BLDG B STE 3
    SAINT GEORGE, UT
    ZIP 84790
  • Phone: (435) 628-0511

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NPI Details

WHITE DOME PEDIATRIC DENTAL LLC is a pediatric dentistry dentist in Saint George, 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. WHITE DOME PEDIATRIC DENTAL LLC NPI is 1780480665. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6025 S. RIVER RD. BLDG B STE 3
SAINT GEORGE, UT
ZIP 84790
Phone: (435) 628-0511

The provider's authorized official is Cody Johnson .
The authorized official title is Owner and has the following contact phone number (435) 628-0511.

The enumeration date for this NPI number is 2/21/2025 and was last updated on 2/21/2025.

Taxonomy Codes

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeNo
21223P0221XDentistPediatric DentistryYes

What is NPI?

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: 11/21/2025

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