OrganizationActive
Slc Pdc PLLC
NPI 1124438916 · Dentist · Salt Lake City, UT
Provider details
- NPI number
- 1124438916
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Jacob Warner, Credentialing Manager(801) 691-1701
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 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
1963 S 1200 E
Ste 103
Salt Lake City, UT 84105-3523
Phone: (801) 466-1212
Fax: (801) 466-1919
Street-level locationGet directions
Mailing address
Po Box 970687
Orem, UT 84097-0687
Other names (DBA / former)
- Doing business as
- Platinum Dental Care
- Doing business as
- Platinum Dental Care
Registry dates
- Enumerated
- 2014-05-01
- Last updated
- 2021-07-02
- Certified
- 2021-07-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.