OrganizationActive
Provo Family Dentistry, LLC
NPI 1063923258 · Dental Clinic/Center · Provo, UT
Provider details
- NPI number
- 1063923258
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Christy Hardman, Office Manager(801) 373-2693
- License
- 275985-9922 (UT)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1355 N University Ave Ste 310
Provo, UT 84604-2721
Phone: (801) 373-2693
Street-level locationGet directions
Mailing address
1355 N University Ave Ste 310
Provo, UT 84604-2721
Other names (DBA / former)
- Doing business as
- The Dental Edge
Registry dates
- Enumerated
- 2017-10-16
- Last updated
- 2017-10-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.