SALT LAKE ENDODONTICS NPI 1568612133

NPI Information

  • NPI: 1568612133
  • Provider Name: SALT LAKE ENDODONTICS
  • Classification: Dentist - 1223E0200X
  • Specialization: Endodontics
  • Entity Type: Organization
  • CLIA Number: 46D2127134
  • Address: 1955 S 1300 E STE 6
    SALT LAKE CITY, UT
    ZIP 84105
  • Phone: (801) 487-0758

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NPI Details

SALT LAKE ENDODONTICS is an endodontics dentist in Salt Lake City, UT. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. SALT LAKE ENDODONTICS NPI is 1568612133. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1955 S 1300 E STE 6
SALT LAKE CITY, UT
ZIP 84105-684
Phone: (801) 487-0758
Fax: (801) 487-0750

The provider's authorized official is Mitchell G Rudd .
The authorized official title is Presidient and has the following contact phone number (801) 487-0758.

The CLIA number assigned to this NPI record is 46D2127134 - other - syringe exchange with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/19/2008 and was last updated on 9/19/2008.

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
11223E0200XDentistEndodontics5328713-9922UTAHYes

What is NPI?

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This page was last updated on: 11/21/2025

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