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

Southridge Pediatric Dentistry

Organization Dentist · NPI 1225249683

Southridge Pediatric Dentistry is a Dentist in South Jordan, Utah. Licensed in Utah. Registered with an NPI since 2007.

Licensed in
UT
In the registry since
2007
Specialties on file
2

Practice location Address checks out

2651 W 10400 S #103
South Jordan, UT 84095
Phone: (801) 445-1515
Fax: (801) 446-5290
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 343291 (UT)
Dentist Taxonomy 122300000X · Licence 5667938 (UT)

Record details

NPI number1225249683
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Roth — Owner · (801) 446-1515
NPI enumeratedMay 25, 2007
Last updated in NPPESAugust 22, 2020
Mailing address2651 W. 10400 S. #103, South Jordan, UT 84095

Other providers in South Jordan