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STANSBURY PEDIATRIC DENTISTRY AND ORTHODONTICS NPI 1679754766


NPI Information

NPI: 1679754766
Provider Name: STANSBURY PEDIATRIC DENTISTRY AND ORTHODONTICS

Doing Business As: DENTISTRY 4 THE KIDS

Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
220 MILLPOND
SUITE #106
STANSBURY PARK, UT
ZIP 84074
Phone: (435) 840-1025
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STANSBURY PEDIATRIC DENTISTRY AND ORTHODONTICS is a pediatric dentistry dentist in Stansbury Park, UT. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. STANSBURY PEDIATRIC DENTISTRY AND ORTHODONTICS NPI is 1679754766. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dentistry 4 The Kids.

The provider's business location address is:

220 MILLPOND
SUITE #106
STANSBURY PARK, UT
ZIP 84074-745
Phone: (435) 840-1025
Fax: (435) 882-2680

The provider's authorized official is Trisha Richard Taylor .
The authorized official title is Dentist and has the following contact phone number (435) 840-1025.

The enumeration date for this NPI number is 11/17/2007 and was last updated on 11/17/2007.


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
11223P0221XDentistPediatric Dentistry4753208-9923UTAHYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1296664784000MEDICAIDUTAH

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

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