Healthcare Provider Details

I. General information

NPI: 1407720899
Provider Name (Legal Business Name): ROY PEDIATRIC DENTISTRY LLC DBA WEE CARE PEDIATRIC DENTISTRY AND ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5682 S 3500 W UNIT A
ROY UT
84067-9108
US

IV. Provider business mailing address

5682 S 3500 W UNIT A
ROY UT
84067-9108
US

V. Phone/Fax

Practice location:
  • Phone: 801-773-8644
  • Fax: 801-773-9828
Mailing address:
  • Phone: 801-773-8644
  • Fax: 801-773-9828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CHARLES ODION
Title or Position: DENTAL PROVIDER
Credential: DDS
Phone: 801-254-9700