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

Clubhouse Pediatric Dentistry of West Jordan

Organization Pediatric Dentistry · NPI 1639654684

Clubhouse Pediatric Dentistry of West Jordan is a Pediatric Dentistry in Midvale, Utah. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

1108 E South Union Ave
Midvale, UT 84047-2904
Phone: (208) 520-1514
Show map & directions

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

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1639654684
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCapstone LLC
Authorized official Jennifer Robison — Credentialing Coordinator · (208) 520-1514
NPI enumeratedSeptember 26, 2018
Last updated in NPPESSeptember 26, 2018
Mailing address1108 E South Union Ave, Midvale, UT 84047-2904

Other providers in Midvale