Providence Pdc Pllc
Providence Pdc Pllc is a healthcare organization registered as Dentist in Providence, UT, holding Type 2 (organization) NPI 1598390494 since 2020. The authorized official on file is Jacob Warner, Credentialing Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1598390494 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Providence Pdc Pllc |
| Other name | <Unavail> |
| Practice address | 169 N GATEWAY DR, SUITE #105, Providence, UT, 84332 |
| Phone | 4356102474 |
| Enumeration date | 2020-03-11 |
| Last updated in NPPES | 2020-03-11 |
Authorized official
| Name | Jacob Warner |
|---|---|
| Title | Credentialing Manager |
| Phone | 8016911701 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 122300000X | Dentist | Primary | — | — |
Copy-ready billing details
Provider: Providence Pdc Pllc NPI: 1598390494 Taxonomy: 122300000X (Dentist) Address: 169 N GATEWAY DR, SUITE #105, Providence, UT, 84332
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1366111379 | Alexander Gerber | Individual | Physician Assistant | Providence, UT |
Verify this record
Cross-check NPI 1598390494 against the authoritative CMS record: view Providence Pdc Pllc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Providence Pdc Pllc located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-03-11.