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INTERMOUNTAIN DENTAL ASSOCIATES - SURGICAL ASSOCIATES NPI 1598033409


NPI Information

NPI: 1598033409
Provider Name: INTERMOUNTAIN DENTAL ASSOCIATES - SURGICAL ASSOCIATES
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 46D0707935

Address:
2721 N 400 E
SUITE 2
NORTH OGDEN, UT
ZIP 84414
Phone: (801) 782-5682
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INTERMOUNTAIN DENTAL ASSOCIATES - SURGICAL ASSOCIATES is an oral and maxillofacial surgery dentist in North Ogden, UT. The provider is the specialty of dentistry which includes 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. INTERMOUNTAIN DENTAL ASSOCIATES - SURGICAL ASSOCIATES NPI is 1598033409. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2721 N 400 E
SUITE 2
NORTH OGDEN, UT
ZIP 84414-393
Phone: (801) 782-5682
Fax: (801) 786-0520

The provider's authorized official is Vicki Lewis .
The authorized official title is Specialist Coordinator and has the following contact phone number (801) 782-5682.

The CLIA number assigned to this NPI record is 46D0707935 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 12/6/2011 and was last updated on 12/6/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery144024-9922UTAHYes

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: 11/14/2023

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