Healthcare Provider Details

I. General information

NPI: 1871414680
Provider Name (Legal Business Name): LM DENTISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4342 E PONY EXPRESS PKWY STE 100
EAGLE MOUNTAIN UT
84005-5773
US

IV. Provider business mailing address

4342 E PONY EXPRESS PKWY STE 100
EAGLE MOUNTAIN UT
84005-5773
US

V. Phone/Fax

Practice location:
  • Phone: 801-830-4486
  • Fax:
Mailing address:
  • Phone: 801-830-4486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. JARED FAUSNAUGHT
Title or Position: DENTIST
Credential: DDS
Phone: 801-717-6505