OrganizationActive
Pdc Provo LLC
NPI 1396893012 · Dentist · Provo, UT
Pdc Provo LLC is a Dentist organization in Provo, UT (NPI 1396893012).
Provider details
- NPI number
- 1396893012
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Parent organization
- Platinum Dental Group LLC
- Organization subpart
- Yes
- Authorized official
- Amber Johnson, Office Manager(801) 426-6255
- License
- 3192 (UT)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
2520 N Univ Ave
Suite 101
Provo, UT 84604
Phone: (801) 426-6255
Fax: (801) 224-2966
Street-level locationGet directions
Mailing address
2520 N Univ Ave
Provo, UT 84604
Registry dates
- Enumerated
- 2007-01-08
- Last updated
- 2013-01-04
Frequently asked questions
- What is Pdc Provo LLC's NPI number?
- Pdc Provo LLC's National Provider Identifier (NPI) is 1396893012, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pdc Provo LLC?
- Pdc Provo LLC is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Pdc Provo LLC located?
- Pdc Provo LLC's practice location on file with NPPES is 2520 N Univ Ave, Provo, UT 84604.
- What is Pdc Provo LLC's phone number?
- The practice phone number listed in the NPPES registry for Pdc Provo LLC is (801) 426-6255.
- Who is the authorized official for Pdc Provo LLC?
- The authorized official listed on Pdc Provo LLC's NPPES record is Amber Johnson, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pdc Provo LLC's NPI active?
- Yes — Pdc Provo LLC's NPI (1396893012) is active in the NPPES registry as of the last update on 2013-01-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.