SIMPLY WISDOM TEETH PLLC NPI 1255857728

NPI Information

NPI: 1255857728
Provider Name: SIMPLY WISDOM TEETH PLLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
352 E RIVERSIDE DR STE A9
SAINT GEORGE, UT
ZIP 84790
Phone: (435) 652-1243
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SIMPLY WISDOM TEETH PLLC is a dental clinic center in Saint George, UT. SIMPLY WISDOM TEETH PLLC NPI is 1255857728. The provider is registered as an organization entity type.

The provider's business location address is:

352 E RIVERSIDE DR STE A9
SAINT GEORGE, UT
ZIP 84790-812
Phone: (435) 652-1243
Fax: (435) 652-1243

The provider's authorized official is Niels Hendrickson .
The authorized official title is Manager and has the following contact phone number (435) 215-6621.

The enumeration date for this NPI number is 8/16/2017 and was last updated on 7/21/2022.

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	261QD0000X	Clinic/Center	Dental	143297	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	528948205	MEDICAID	UTAH

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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