OrganizationActive
South Provo Pdc PLLC
NPI 1538946207 · Dental Clinic/Center · Provo, UT
South Provo Pdc PLLC is a Dental Clinic/Center organization in Provo, UT (NPI 1538946207).
Provider details
- NPI number
- 1538946207
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Vivian Betancourt, Credentialing Specialist(801) 305-3465
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 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
2211 E Valley Vista Way
Provo, UT 84606-5636
Phone: (385) 412-6964
Fax: (385) 248-5034
Street-level locationGet directions
Mailing address
Po Box 970185
Orem, UT 84097-0185
Registry dates
- Enumerated
- 2023-09-14
- Last updated
- 2023-11-08
- Certified
- 2023-11-08
Frequently asked questions
- What is South Provo Pdc PLLC's NPI number?
- South Provo Pdc PLLC's National Provider Identifier (NPI) is 1538946207, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is South Provo Pdc PLLC?
- South Provo Pdc PLLC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is South Provo Pdc PLLC located?
- South Provo Pdc PLLC's practice location on file with NPPES is 2211 E Valley Vista Way, Provo, UT 84606-5636.
- What is South Provo Pdc PLLC's phone number?
- The practice phone number listed in the NPPES registry for South Provo Pdc PLLC is (385) 412-6964.
- Who is the authorized official for South Provo Pdc PLLC?
- The authorized official listed on South Provo Pdc PLLC's NPPES record is Vivian Betancourt, Credentialing Specialist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is South Provo Pdc PLLC's NPI active?
- Yes — South Provo Pdc PLLC's NPI (1538946207) is active in the NPPES registry as of the last update on 2023-11-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.