Dentist Providers In South Jordan, Utah

Search Dentist NPI records in South Jordan, UT

Search or browse through the NPI records of dentist registered healthcare providers with a business address in South Jordan, UT. The listings include accepted insurance information, Medicare acceptance status, and PECOS enrollment data. The total number of NPI records is 114, of which 38 are registered as organizations and 76 as individuals. A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

67% Individuals

33% Organizations

7% Female

60% Male

67% Individual Providers (76)33% Medical Organizations (38)7% Female Providers (8)60% Male Providers (68)

Map of Providers

We have mapped the Dentist providers in South Jordan, UT to visually represent the practice location of each individual or organization. Click on any of the the pins to see the provider details at that location.

List of Providers

Table of Dentist NPI Profiles in South Jordan, UT
NPI	Name	Address	Insurance	Medicare	PECOS
1023336104	ADAM C STANLEY (Individual)	3632 W SOUTH JORDAN PKWY STE 103 SOUTH JORDAN, UT 84009 (385) 274-4848	Ambetter from Arkansas Health & Wellness Ambetter from Home State Health Ambetter from Sunflower Health Plan Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DentaTrust/DentaSpan EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health TRUASSURE INSURANCE COMPANY UnitedHealthcare	Opted out of Medicare	YES
1033329669	TIMOTHY B. ELISON (Individual)	3556 W 9800 S SUITE 103 SOUTH JORDAN, UT 84095 (801) 446-3549	BEST Life BridgeSpan Health Company Florida Combined Life Guardian Humana Regence BlueCross BlueShield of Utah Select Health	Non-Participating Provider	NO
1063275865	PEAK 5 FAMILY DENTISTRY (Organization)	1680 W REUNION AVE STE 6B SOUTH JORDAN, UT 84095 (385) 368-6745		Non-Participating Provider	NO
1063949782	JOBY CHALUPARAMBIL (Individual)	11758 S DISTRICT DR UNIT 702 SOUTH JORDAN, UT 84095 (409) 939-9437	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Guardian TRUASSURE INSURANCE COMPANY	Non-Participating Provider	NO
1073622817	JOHN SHEA BESS (Individual)	3556 WEST 9800 SOUTH STE 102 SOUTH JORDAN, UT 84095 (801) 280-5558	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	YES
1073804001	THAYNE HENRIE GARDNER (Individual)	1268 W SOUTH JORDAN PKWY SUITE 101 SOUTH JORDAN, UT 84095 (801) 446-8007	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1093138448	SIMPLY DENTAL OF SOUTH JORDAN, LLC SOUTH JORDAN DENTAL (Organization)	1268 W SOUTH JORDAN PKWY SUITE 302 SOUTH JORDAN, UT 84095 (801) 253-3900		Non-Participating Provider	NO
1134536907	COPPER COVE PEDIATRIC DENTISTRY (Organization)	3473 W SOUTH JORDAN PKWY STE 3 SOUTH JORDAN, UT 84095 (801) 446-2080		Non-Participating Provider	NO
1134564388	DANIEL JED SNEDAKER (Individual)	11535 S JORDAN BEND RD SOUTH JORDAN, UT 84095 (801) 360-8868	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	YES
1164527784	HAMID MASSUD OMANA (Individual)	10393 S 1300 W SUITE 100 SOUTH JORDAN, UT 84095 (801) 359-4151	BridgeSpan Health Company Guardian Regence BlueCross BlueShield of Utah Select Health	Non-Participating Provider	NO
1164587796	KENNETH ARTHUR KING (Individual)	10920 RIVER FRONT PKWY ROSEMAN UNIVERSITY OF HEALTH SCIENCES, CODM SOUTH JORDAN, UT 84095 (801) 878-1419	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas DentaTrust/DentaSpan Paramount Paramount Dental	Non-Participating Provider	NO
1164883104	MARC ENSLOW (Individual)	1685 W TOWNE CENTER DR STE A2 SOUTH JORDAN, UT 84095 (801) 254-7003	Ambetter from Arizona Complete Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Arizona BridgeSpan Health Company Delta Dental PPO DentaTrust/DentaSpan EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health Solstice Healthplans of Arizona Inc. UnitedHealthcare	Non-Participating Provider	NO
1174012876	PONY EXRESS ORTHODONTICS, LLC (Organization)	5396 W DAYBREAK PKWY SOUTH JORDAN, UT 84009 (801) 614-7669	UnitedHealthcare	Non-Participating Provider	NO
1194830141	MATTHEW L KJAR (Individual)	1268 W SOUTH JORDAN PKWY SUITE #102 SOUTH JORDAN, UT 84095 (801) 446-1888	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Humana Paramount Paramount Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1194837625	KYLE S CHRISTENSEN (Individual)	1268 W. SOUTH JORDAN PARKWAY SUITE 200 SOUTH JORDAN, UT 84095 (801) 561-8088	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Opted out of Medicare	YES
1205497096	IRENE ISAZA BEVAN (Individual)	3785 W 10400 S SOUTH JORDAN, UT 84095 (801) 253-2249	Anthem Blue Cross and Blue Shield BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	YES
1215213905	DAVID M. S. STEWART DDS PC LITTLE PEOPLE'S DENTAL (Organization)	1268 W SOUTH JORDAN PKWY SUITE 101 SOUTH JORDAN, UT 84095 (801) 446-8007		Non-Participating Provider	NO
1215573522	VANESSA BIKHAZI (Individual)	11501 S 4000 W STE 101 SOUTH JORDAN, UT 84009 (801) 701-2120	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1215987797	RUSSELL WIRTHLIN FARNSWORTH (Individual)	2651 W 10400 S SUITE 103 SOUTH JORDAN, UT 84095 (801) 446-1515	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1225021900	WILLIAM BRENT CARROLL (Individual)	10894 S RIVER FRONT PKWY SOUTH JORDAN, UT 84095 (801) 878-1410		Non-Participating Provider	NO
1225212376	WALTER MEDEN (Individual)	1680 REUNION AVE SUITE 200 SOUTH JORDAN, UT 84095 (801) 446-7800	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	NO
1225249683	SOUTHRIDGE PEDIATRIC DENTISTRY (Organization)	2651 W. 10400 S. #103 SOUTH JORDAN, UT 84095 (801) 445-1515		Non-Participating Provider	NO
1225673429	MOUNTAIN VIEW DENTAL PDC PLLC MOUNTAIN VIEW DENTAL (Organization)	6783 S REDWOOD RD #201 SOUTH JORDAN, UT 84084 (801) 969-8200	UnitedHealthcare	Non-Participating Provider	NO
1225887052	DAVIS ORTHODONTICS PLLC (Organization)	2651 W SOUTH JORDAN PKWY STE 201 SOUTH JORDAN, UT 84095 (801) 254-2700		Non-Participating Provider	NO
1235799388	ALEXANDER HARRIS (Individual)	11501 S 4000 W STE 101 SOUTH JORDAN, UT 84009 (801) 701-2120	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Regence BlueCross BlueShield of Utah	Non-Participating Provider	YES
1235923103	SAVANNAH BROOME (Individual)	10894 S RIVER FRONT PKWY SOUTH JORDAN, UT 84095 (801) 878-1200		Non-Participating Provider	NO
1245317759	MATTHEW MCINNES (Individual)	3556 W 9800 S STE 102 SOUTH JORDAN, UT 84095 (801) 280-5558	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	YES
1245720788	PONY EXPRESS DENTALKIDS, LLC (Organization)	5396 W DAYBREAK PKWY SOUTH JORDAN, UT 84009 (801) 614-7669		Non-Participating Provider	NO
1245814169	BANGERTER DENTAL, LLC (Organization)	3672 W SOUTH JORDAN PKWY STE 203 SOUTH JORDAN, UT 84009 (801) 550-5013	UnitedHealthcare	Non-Participating Provider	NO
1255024816	LANCE DAVID STARLING (Individual)	5087 W LAKE TERRACE AVE SOUTH JORDAN, UT 84009 (801) 360-4770	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1265988844	IAN GUZY (Individual)	5396 W DAYBREAK PKWY SOUTH JORDAN, UT 84009 (801) 614-7669	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Guardian Humana Regence BlueCross BlueShield of Utah Renaissance Dental	Non-Participating Provider	NO
1275634743	ROBERT CURTIS PAXTON (Individual)	1268 W SOUTH JORDAN PKWY SUITE 302 SOUTH JORDAN, UT 84095 (801) 253-3900	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DentaTrust/DentaSpan EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	YES
1285685594	DAVID CHRISTIAN ROTH (Individual)	2651 W 10400 S SUITE 103 SOUTH JORDAN, UT 84095 (801) 446-1515	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1295095396	MICHAEL B. WARNER, DMD, LLC ASPIRE DENTAL (Organization)	2651 W 10400 S SUITE 101 SOUTH JORDAN, UT 84095 (801) 254-4454	UnitedHealthcare	Non-Participating Provider	NO
1295490100	THAYNE GARDNER DDS, PLLC (Organization)	1268 W SOUTH JORDAN PKWY STE 101 SOUTH JORDAN, UT 84095 (801) 446-8007	UnitedHealthcare	Non-Participating Provider	NO
1316442841	SJ ORAL SURGERY PC SOUTH JORDAN ORAL AND FACIAL SURGERY (Organization)	3632 W SOUTH JORDAN PKWY STE 103 SOUTH JORDAN, UT 84009 (580) 355-6000	UnitedHealthcare	Non-Participating Provider	NO
1316767080	ANDREW HAWKS (Individual)	10654 S RIVER HEIGHTS DR STE 310 SOUTH JORDAN, UT 84095 (801) 254-6900		Non-Participating Provider	NO
1326167354	JARED M BROWN (Individual)	11748 S 3600 W SOUTH JORDAN, UT 84095 (801) 938-3412	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Opted out of Medicare	YES
1336573120	JAMES R DONAHOO (Individual)	10894 S. RIVER FRONT PARKWAY SOUTH JORDAN, UT 84095 (801) 878-1406		Non-Participating Provider	NO
1336706043	SOUTH JORDAN PDC PLLC (Organization)	10458 S REDWOOD RD SOUTH JORDAN, UT 84095 (801) 302-8989	UnitedHealthcare	Non-Participating Provider	NO
1346510054	RICHARD D TUTTLE (Individual)	505 W 10200 S SOUTH JORDAN, UT 84095 (801) 726-1665		Non-Participating Provider	NO
1346731122	JOHN TYLER ZAGOREC (Individual)	3785 W 10400 S STE 103 SOUTH JORDAN, UT 84009 (801) 253-2249	Ambetter from Meridian Ambetter Health Anthem Blue Cross and Blue Shield BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Renaissance Dental Select Health	Non-Participating Provider	YES
1386277689	SENIOR SMILES UTAH LLC (Organization)	10597 S BEACH COMBER WAY SOUTH JORDAN, UT 84009 (801) 415-6847		Non-Participating Provider	NO
1417315656	PETERSEN DENTAL LLC (Organization)	10458 S REDWOOD RD SOUTH JORDAN, UT 84095 (801) 302-8989		Non-Participating Provider	NO
1417363821	ROSEMAN UNIVERSITY OF HEALTH SCIENCES, A NEVADA NON-PROFIT CORP (Organization)	10894 S RIVER FRONT PKWY SOUTH JORDAN, UT 84095 (801) 878-1406	Ambetter from Arizona Complete Health UnitedHealthcare	Non-Participating Provider	NO
1427452614	GENESIS DENTAL OF SOUTH JORDAN GENESIS DENTAL AT THE DISTRICT (Organization)	11531 S DISTRICT DR STE 600 SOUTH JORDAN, UT 84095 (801) 254-7272		Non-Participating Provider	NO
1427785989	DUNCAN ALEXANDER CHAPPLE (Individual)	4040 W DAYBREAK PKWY SOUTH JORDAN, UT 84009 (385) 279-4334	Anthem Blue Cross and Blue Shield BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1437370764	JAMES DAVID LUND (Individual)	10430 S 2700 W SOUTH JORDAN, UT 84095 (801) 254-7777	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	NO
1437530334	JOSHUA SHARP (Individual)	1268 W SOUTH JORDAN PKWY SUITE 302 SOUTH JORDAN, UT 84095 (801) 915-5947	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Guardian Humana Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1437698750	RYAN SEARS (Individual)	10894 SO. RIVER FRONT PARKWAY SOUTH JORDAN, UT 84095 (208) 360-1169	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DentaTrust/DentaSpan EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental UnitedHealthcare	Maybe Accepts Medicare	YES
1447315692	DAVID LYNN ALVORD (Individual)	1685 W 10600 S SUITE A2 SOUTH JORDAN, UT 84095 (801) 254-7003	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana Renaissance Dental	Non-Participating Provider	NO
1457432643	CHRIS WADE KEEFE (Individual)	10393 S 1300 W SOUTH JORDAN, UT 84095 (801) 254-1400	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	NO
1457703084	JUSTIN COURAUD (Individual)	3672 W SOUTH JORDAN PKWY SOUTH JORDAN, UT 84009 (801) 878-1700	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1457797185	RACHANA ASHOK HEGDE (Individual)	10920 S RIVER FRONT PARKWAY COLLEGE OF DENTAL MEDICINE ROSEMAN UNIVERSITY OF HEALTH SOUTH JORDAN, UT 84095 (840) 878-1482	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Humana Molina Healthcare Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	NO
1497114870	TRENTON JOHNSON (Individual)	10157 S 940 W SOUTH JORDAN, UT 84095 (801) 879-0400	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1508069105	CHRISTOPHER JOSEPH PRICE (Individual)	3473 W SOUTH JORDAN PKWY STE 4 SOUTH JORDAN, UT 84095 (801) 446-4428	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DeltaCare USA EMI Health Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1518106624	TODD LYAL CHRISTENSEN (Individual)	10393 S TEMPLE DR STE 100 SOUTH JORDAN, UT 84095 (801) 618-2800	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DeltaCare USA EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1528594892	SPENCER PUGMIRE (Individual)	3473 W SOUTH JORDAN PKWY SOUTH JORDAN, UT 84095 (801) 388-7670	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama BridgeSpan Health Company Delta Dental PPO DentaTrust/DentaSpan EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1538182373	TROY STEVEN THOMSON (Individual)	1268 W SOUTH JORDAN PKWY SUITE #102 SOUTH JORDAN, UT 84095 (801) 446-1888	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Humana Paramount Paramount Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1538394846	DAVID EDWARDS FAERBER (Individual)	3672 W SOUTH JORDAN PKWY # D104 SOUTH JORDAN, UT 84095 (801) 878-1700	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DentaTrust/DentaSpan EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1538505110	LISA ROMNEY (Individual)	3632 W SOUTH JORDAN PKWY SUITE 202 SOUTH JORDAN, UT 84095 (801) 446-4668	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Paramount Paramount Dental Select Health	Non-Participating Provider	NO
1538774492	RYAN HUNTER (Individual)	10458 S REDWOOD RD SOUTH JORDAN, UT 84095 (801) 312-8085	Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Florida Combined Life Guardian Humana Renaissance Dental	Non-Participating Provider	NO
1548359425	STEVEN D SMITH (Individual)	1268 W SOUTH JORDAN PKWY STE 302 SOUTH JORDAN, UT 84095 (801) 253-3900	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	YES
1558572834	BRYAN P. HORSLEY (Individual)	3632 W. SOUTH JORDAN PARKWAY #201 SOUTH JORDAN, UT 84095 (801) 254-6900	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Florida Combined Life Humana Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	NO
1568687820	DAVID J COATES (Individual)	2651 W SOUTH JORDAN PKWY SUITE 203 SOUTH JORDAN, UT 84095 (801) 254-5553	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1578689055	SHARON ANGELICI (Individual)	10920 S RIVER FRONT PKWY #557 SOUTH JORDAN, UT 84095 (801) 878-1474		Non-Participating Provider	NO
1588728646	JUDD ELLIS PARTRIDGE (Individual)	4775 W DAYBREAK PKWY STE 104 SOUTH JORDAN, UT 84009 (801) 280-5535	Aetna CVS Health Ambetter from Meridian Ambetter Health Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Opted out of Medicare	YES
1598755472	ADAM ROSS BUSHELL (Individual)	3473 W SOUTH JORDAN PKWY STE 3 SOUTH JORDAN, UT 84095 (801) 446-2080	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DentaTrust/DentaSpan EMI Health Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1649431040	DANIEL L HARRIS (Individual)	10393 S 1300 W SOUTH JORDAN, UT 84095 (801) 254-1400	BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1649488578	RODNEY G PAYNE (Individual)	3668 W 9800 S SOUTH JORDAN, UT 84095 (801) 260-1515	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1649848904	BRENDON THUESON TINGEY (Individual)	11501 S 4000 W STE 101 SOUTH JORDAN, UT 84009 (801) 701-2120	Anthem Blue Cross and Blue Shield BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DeltaCare USA DentaTrust/DentaSpan EMI Health Florida Combined Life Humana Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	YES
1659533859	MASON SULLIVAN WELLS (Individual)	10393 SOUTH 1300 WEST SOUTH JORDAN, UT 84095 (801) 254-1400	BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Regence BlueCross BlueShield of Utah Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1659542215	BENJAMIN EARL WALL (Individual)	10894 S RIVER FRONT PKWY SOUTH JORDAN, UT 84095 (801) 878-1471	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Paramount Paramount Dental Renaissance Dental Select Health TRUASSURE INSURANCE COMPANY	Non-Participating Provider	NO
1669076188	RYAN DAVIS (Individual)	2651 W SOUTH JORDAN PKWY STE 201 SOUTH JORDAN, UT 84095 (801) 254-2700	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Delta Dental PPO EMI Health Guardian Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1669634846	PAUL LORIN CHILD (Individual)	10706 S RIVER FRONT PKWY SOUTH JORDAN, UT 84095 (801) 252-1460	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1679055081	SMART SMILES UTAH (Organization)	10597 S BEACH COMBER WAY SOUTH JORDAN, UT 84009 (801) 649-4222		Non-Participating Provider	NO
1679823058	MICHAEL R. COTTAM MS DMD PLLC (Organization)	4775 W DAYBREAK PKWY SOUTH JORDAN, UT 84095 (801) 261-3178	UnitedHealthcare	Non-Participating Provider	NO
1689719759	JOHN D. MILLER (Individual)	10393 S 1300 W SOUTH JORDAN, UT 84095 (801) 254-1400	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1699317685	DAYBREAK PDC PLLC (Organization)	4040 WEST DAYBREAK PKWY SUITE 103 SOUTH JORDAN, UT 84009 (385) 279-4334	UnitedHealthcare	Non-Participating Provider	NO
1700391828	DENTISTS OF SOUTH JORDAN, LLP (Organization)	11501 S 4000 W STE 101 SOUTH JORDAN, UT 84009 (801) 701-2120		Non-Participating Provider	NO
1700409695	WASATCH DENTAL GROUP LLC (Organization)	1685 W TOWNE CENTER DR SOUTH JORDAN, UT 84095 (801) 254-7003		Non-Participating Provider	NO
1700587391	OWEN COHEN (Individual)	10894 S RIVER FRONT PKWY SOUTH JORDAN, UT 84095 (801) 878-1200	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1730745456	MICHAEL THOMAS (Individual)	4775 W DAYBREAK PKWY STE 201 SOUTH JORDAN, UT 84009 (801) 280-1911	BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Humana Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1760022768	SOJO DENTAL (Organization)	3473 W SOUTH JORDAN PARKWAY STE. 2 SOUTH JORDAN, UT 84095 (801) 260-9150		Non-Participating Provider	NO
1760212443	CHRISTENSEN ORTHODONTICS LLC (Organization)	10393 S TEMPLE DR STE 100 SOUTH JORDAN, UT 84095 (801) 618-2800		Non-Participating Provider	NO
1780323964	KEVIN STAPLETON (Individual)	10458 S REDWOOD RD SOUTH JORDAN, UT 84095 (801) 312-8085	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DentaTrust/DentaSpan EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1780711432	GERARDO F. MAYMI, D.M.D. PC JERRY F. MAYMI & ASSOCIATES (Organization)	2651 W SOUTH JORDAN PKWY SUITE 101 SOUTH JORDAN, UT 84095 (801) 253-7553	UnitedHealthcare	Non-Participating Provider	NO
1790301877	TAYLOR DUDLEY (Individual)	5396 W DAYBREAK PKWY SOUTH JORDAN, UT 84009 (801) 614-7669	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental	Non-Participating Provider	NO
1801198551	JAMES D JOHNSON DDS PC (Organization)	2651 W 10400 S STE 202 SOUTH JORDAN, UT 84095 (801) 253-0595	DentaTrust/DentaSpan	Non-Participating Provider	NO
1811057995	ORTHODONTIC CENTER (Organization)	3556 W 9800 S SUITE 103 SOUTH JORDAN, UT 84095 (801) 446-3549		Non-Participating Provider	NO
1811396260	OUT OF THIS WORLD DENTISTRY SJ PC OUT OF THIS WORLD SJ (Organization)	10426 S. 4000 W. SOUTH JORDAN, UT 84009 (801) 260-0400	DentaTrust/DentaSpan	Non-Participating Provider	NO
1821157918	DOUGLAS M ANDERSON (Individual)	2651 W SOUTH JORDAN PKWY STE 201 SOUTH JORDAN, UT 84095 (801) 254-2700	BridgeSpan Health Company Guardian Regence BlueCross BlueShield of Utah	Non-Participating Provider	NO
1821525288	JUSTIN VANBIBBER DMD PC DAYBREAK SMILES PEDIATRIC DENTISTRY (Organization)	4775 W DAYBREAK PKWY STE 103 SOUTH JORDAN, UT 84009 (801) 999-4640		Non-Participating Provider	NO
1821621129	PRO SMILES UTAH LLC (Organization)	10597 S BEACH COMBER WAY SOUTH JORDAN, UT 84009 (801) 413-2814		Non-Participating Provider	NO
1831630763	TINA PATEL (Individual)	11501 S 4000 W STE 101 SOUTH JORDAN, UT 84009 (017) 012-1208	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dental Health Services Florida Combined Life Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental	Non-Participating Provider	NO
1831758283	MENAKHEM DAVIDOV (Individual)	3648 W 9800 S SOUTH JORDAN, UT 84009 (801) 260-0100	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1851586374	HORSLEY ORTHODONTICS (Organization)	3632 W. SOUTH JORDAN PARKWAY, #201 SOUTH JORDAN, UT 84095 (801) 254-6900	UnitedHealthcare	Non-Participating Provider	NO
1871978981	JACOB BOYACK (Individual)	2651 W SOUTH JORDAN PKWY STE 203 SOUTH JORDAN, UT 84095 (801) 254-5553	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Guardian Humana Paramount Paramount Dental Premera Blue Cross Blue Shield of Alaska Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1881324291	AUSTIN TROY WILLIAMS (Individual)	3473 W SOUTH JORDAN PKWY STE 103 SOUTH JORDAN, UT 84095 (801) 876-5551	Ambetter from Arizona Complete Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah UnitedHealthcare	Non-Participating Provider	NO
1881467207	FAMILIES FIRST PEDIATRIC DENTISTRY (Organization)	1320 W SOUTH JORDAN PKWY SOUTH JORDAN, UT 84095 (801) 254-9700	UnitedHealthcare	Non-Participating Provider	NO
1881881134	J. MICHAEL DUNN (Individual)	11659 S REDWOOD RD SOUTH JORDAN, UT 84095 (801) 253-3010	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DentaTrust/DentaSpan EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	YES
1881953966	DAVID DENSLEY (Individual)	ROSEMAN UNIVERSITY 10920 S RIVER FRONT PKWY SOUTH JORDAN, UT 84095 (801) 878-1200	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1891856639	CURTIS BRIMLEY (Individual)	1388 SKYSCAPE WAY SOUTH JORDAN, UT 84095 (801) 664-8895	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DentaTrust/DentaSpan EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Renaissance Dental Select Health UnitedHealthcare	Non-Participating Provider	NO
1902321045	CLARK DENTAL P.C. (Organization)	10597 S BEACH COMBER WAY SOUTH JORDAN, UT 84009 (208) 317-8555	UnitedHealthcare	Non-Participating Provider	NO
1912090804	STUART LINDSAY (Individual)	3672 W SOUTH JORDAN PKWY SUITE D104 SOUTH JORDAN, UT 84095 (801) 599-2480	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Paramount Paramount Dental	Non-Participating Provider	NO
1932990678	SOJO32 LLC (Organization)	3473 W SOUTH JORDAN PKWY STE 2 SOUTH JORDAN, UT 84095 (801) 260-9150		Non-Participating Provider	NO
1942054648	PAYNE PEDIATRIC DENTISTRY (Organization)	3473 W SOUTH JORDAN PKWY STE 3 SOUTH JORDAN, UT 84095 (801) 331-8449		Non-Participating Provider	NO
1942235296	RYAN HYMAS WILLDEN (Individual)	10654 S RIVER HEIGHTS DR STE 330 SOUTH JORDAN, UT 84095 (801) 446-4668	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO DeltaCare USA EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	NO
1952794851	UNIVERSITY OF UTAH DENTAL SERVICES UUHC SOUTH JORDAN HEALTH CENTER - ENT-DENTAL (Organization)	5126 W DAYBREAK PKWY SOUTH JORDAN, UT 84095 (801) 213-4500	Aetna CVS Health	Non-Participating Provider	NO
1972100295	RILEY HUNSAKER (Individual)	10654 S RIVER HEIGHTS DR SOUTH JORDAN, UT 84095 (801) 472-7919	Select Health	Non-Participating Provider	NO
1972648293	JAMES D JOHNSON (Individual)	2651 W SOUTH JORDAN PKWY STE 202 SOUTH JORDAN, UT 84095 (801) 253-0595	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	NO
1982365714	BARETT D ANDREASEN (Individual)	914 W BROOKCREST CIR SOUTH JORDAN, UT 84095 (424) 226-2174		Non-Participating Provider	NO
1982828950	GERARDO F MAYMI (Individual)	3672 W SOUTH JORDAN PKWY SUITE 203 SOUTH JORDAN, UT 84095 (801) 253-7553	Anthem Blue Cross and Blue Shield BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BridgeSpan Health Company Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Regence BlueCross BlueShield of Utah Select Health UnitedHealthcare	Non-Participating Provider	NO
1992930861	WILLDEN FAMILY DENTAL INC. (Organization)	3632 W SOUTH JORDAN PKWY SUITE 202 SOUTH JORDAN, UT 84095 (801) 446-4668	UnitedHealthcare	Non-Participating Provider	NO

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