Individual provider · Type 1 NPI

Micah G. Mortensen, DDS, M.S.D.

Orthodontics and Dentofacial Orthopedics Dentistry · Salt Lake City, UT

NPI number 1891857579 Active

Practice location

6287 S Redwood Rd Ste 202
Salt Lake City, UT 84123-6655

Call (801) 262-3777 Map

Mailing address

15359 W Columbine Dr
Surprise, AZ 85379-9190

Other practice locations

263 Country Club, Ste 104, Stansbury Park, UT 84074-9602 · (435) 579-3800
3535 S Market St Ste 125, West Valley City, UT 84119-3617 · (801) 966-6681
13825 S Redwood Rd, Bluffdale, UT 84065-5222 · (801) 515-5858
4651 W 13400 S, Riverton, UT 84096-6419 · (801) 515-5858

Specialties and licenses

Taxonomy	Code	License
Orthodontics and Dentofacial Orthopedics Dentistry Primary	1223X0400X	4726746-9921 (UT)

Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…

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About NPI 1891857579

Micah G. Mortensen, DDS, M.S.D.'s National Provider Identifier is 1891857579, issued on Dec 15, 2006. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Salt Lake City, UT. The record was last updated on Jun 15, 2022.