MEDICARE: TEMPLE HILL ORTHODONTIC SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1518837376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEMPLE HILL ORTHODONTIC SERVICES PLLC

Provider Business Mailing Address
First Line	:	4317 N PONY EXPRESS PKWY STE 210
Second Line	:
City	:	EAGLE MOUNTAIN
State	:	UT
Zip	:	84005-1230
Country	:	US
Telephone Number	:	801-762-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4317 N PONY EXPRESS PKWY STE 210
Second Line	:
City	:	EAGLE MOUNTAIN
State	:	UT
Zip	:	84005-1230
Country	:	US
Telephone Number	:	801-762-6400
Fax Number	:

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	STEPHEN MICHAEL WHITE
Credential	:	DDS, MSD
Telephone Number	:	970-889-9396

Provider Enumeration Date	:	11/07/2025
Last Update Date	:	11/07/2025

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