OrganizationActive
Wasatch Periodontal Specialists LLC
NPI 1962162412 · Periodontics · Salt Lake City, UT
Provider details
- NPI number
- 1962162412
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Daniel Thunell, Member(801) 783-6249
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
4252 S Highland Dr Ste 101
Salt Lake City, UT 84124-2684
Phone: (801) 783-6249
Street-level locationGet directions
Mailing address
4252 S Highland Dr Ste 101
Salt Lake City, UT 84124-2684
Other names (DBA / former)
- Doing business as
- Wasatch Periodontics
Registry dates
- Enumerated
- 2021-12-26
- Last updated
- 2021-12-26
- Certified
- 2021-12-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.