Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Academy Dental LLC

Organization Advanced Practice Dental Therapist · NPI 1184132623

Academy Dental LLC is an Advanced Practice Dental Therapist in Provo, Utah. Licensed in Utah. Registered with an NPI since 2018.

Licensed in
UT
In the registry since
2018
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

488 N 100 E St
Provo, UT 84606
Phone: (801) 374-0867
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Advanced Practice Dental Therapist (primary) Taxonomy 125K00000X · Licence 372923 (UT)
Advanced Practice Dental Therapist Taxonomy 125K00000X · Licence 8372408-9922 (UT)

Record details

NPI number1184132623
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationAcademy Dental LLC
Authorized official Corbin Matthews — Owner · (801) 473-6455
Other names Academy Square Dental Care
NPI enumeratedJanuary 18, 2018
Last updated in NPPESJanuary 18, 2018
Mailing address488 N 100 E St., Provo, UT 84606