# WASATCH PEDIATRICS - SALT LAKE DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WASATCH PEDIATRICS, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1982573366
- **Legal business name:** WASATCH PEDIATRICS, INC
- **Authorized official:** ALYSHIA RICE (PROVIDER RELATIONS)
- **Authorized official phone:** (801) 453-9625

## Contact information

- **Practice address:** 3838 S 700 E STE 200, SALT LAKE CITY, UT 84106-1466
- **Practice address phone:** (801) 453-9625
- **Practice address fax:** (801) 944-7347
- **Mailing address:** 9071 S 1300 W STE 205, WEST JORDAN, UT 84088-6725
- **Mailing address phone:** (801) 453-9625
- **Mailing address fax:** (801) 944-7347

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | NULL | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 11/03/2025
- **Last updated:** 12/22/2025