MR. JARED WAYNE MACK DDS NPI 1306092663

NPI Information

NPI: 1306092663
Provider Name: MR. JARED WAYNE MACK, DDS
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

Address:
624 S 1000 E STE 17
ST GEORGE, UT
ZIP 84790
Phone: (435) 289-6600
Get Directions

MR. Jared Wayne Mack, DDS is an oral and maxillofacial surgery dentist in St George, UT. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. MR. Jared Wayne Mack, DDS NPI is 1306092663. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

624 S 1000 E STE 17
ST GEORGE, UT
ZIP 84790-898
Phone: (435) 289-6600
Fax: (435) 289-6900

The enumeration date for this NPI number is 8/18/2008 and was last updated on 1/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		57690	CALIFORNIA	No
2	1223S0112X	Dentist	Oral and Maxillofacial Surgery	57690	CALIFORNIA	No
3	390200000X	Student in an Organized Health Care Education/Training Program				No
4	1223S0112X	Dentist	Oral and Maxillofacial Surgery	11959048	UTAH	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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