Healthcare Provider Details

I. General information

NPI: 1639801319
Provider Name (Legal Business Name): THE POINT PEDIATRIC DENTISTRY. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14629 S PORTER ROCKWELL BLVD STE 104
BLUFFDALE UT
84065-1967
US

IV. Provider business mailing address

3855 W 7800 S STE 200
WEST JORDAN UT
84088-5563
US

V. Phone/Fax

Practice location:
  • Phone: 801-890-1161
  • Fax:
Mailing address:
  • Phone: 801-282-1802
  • Fax: 801-282-6244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: LISA GRAHAM
Title or Position: MANAGER
Credential:
Phone: 801-890-1161