Healthcare Provider Details

I. General information

NPI: 1841133071
Provider Name (Legal Business Name): JET DENTAL OF SOUTH CAROLINA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 N TRIUMPH BLVD STE G50
LEHI UT
84043-6108
US

IV. Provider business mailing address

3451 N TRIUMPH BLVD STE G50
LEHI UT
84043-6108
US

V. Phone/Fax

Practice location:
  • Phone: 801-430-9262
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE HARDING
Title or Position: OWNER
Credential: DDS
Phone: 801-430-9262