MEDICARE: CREEK ROAD ORTHODONTICS AND PEDIATRIC DENTISTRY

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	76505	UT
2	1223P0221X	Pediatric Dentistry	76505	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912274051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREEK ROAD ORTHODONTICS AND PEDIATRIC DENTISTRY

Provider Business Mailing Address
First Line	:	7410 CREEK RD
Second Line	:	SUITE #200
City	:	SANDY
State	:	UT
Zip	:	84093-6140
Country	:	US
Telephone Number	:	801-562-5505
Fax Number	:

Provider Business Practice Location Address
First Line	:	7410 CREEK RD
Second Line	:	SUITE #200
City	:	SANDY
State	:	UT
Zip	:	84093-6140
Country	:	US
Telephone Number	:	801-562-5505
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. BARNEY TODD OLSEN
Credential	:	D.D.S., M.S.
Telephone Number	:	801-562-5505

Provider Enumeration Date	:	11/17/2011
Last Update Date	:	11/17/2011

Similar Medicare Providers

1811964521 — JONATHAN M RASMUSSEN DDS
Practice Location Address:

7410 CREEK RD
SANDY, UT
84093-6140

Practice Phone: 801-352-7889
Practice Fax:

1447623830 — GREAT SMILES DENTAL CLINIC LLC
Practice Location Address:

7410 S CREEK RD , #303
SANDY, UT
84093-6140

Practice Phone: 801-642-4080
Practice Fax:

1295351278 — HEALTHY MIND SET INTL INC
Practice Location Address:

7410 S CREEK RD STE D100
SANDY, UT
84093-6140

Practice Phone: 801-816-1010
Practice Fax:

1881696904 — DR. BRIAN LEE HOMER D.M.D.
Practice Location Address:

7369 CREEK RD
SANDY, UT
84093-6154

Practice Phone: 801-566-5577
Practice Fax: 801-566-4848

1710988548 — DR. RODNEY C DAVIS DC
Practice Location Address:

2061 E 9400 S
SANDY, UT
84093-3128

Practice Phone: 801-733-0550
Practice Fax: 801-733-0075

1396737490 — MARK CHRISTIAN ROBISON MD
Practice Location Address:

1982 E VISCOUNTI CV
SANDY, UT
84093-1059

Practice Phone: 612-990-6018
Practice Fax:

Directions to “CREEK ROAD ORTHODONTICS AND PEDIATRIC DENTISTRY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.