OrganizationActive
Pony Express Dental LLC
NPI 1609315480 · Dental Clinic/Center · Eagle Mountain, UT
Provider details
- NPI number
- 1609315480
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Lake Mountain Health, LLC
- Organization subpart
- Yes
- Authorized official
- Michael Tornow, Coo(505) 947-4252
- License
- 5015649 (UT)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
1308 E. Eagle Mountain Blvd
Eagle Mountain, UT 84005
Phone: (801) 876-7669
Street-level locationGet directions
Mailing address
219 E 12300 S
Draper, UT 84020-6970
Registry dates
- Enumerated
- 2017-02-14
- Last updated
- 2017-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.