DR. MATTHEW BLAKE HILLSTEAD (NPI# 1063709244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063709244 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW BLAKE HILLSTEAD |
| Credential | D.D.S. |
| Practice Address |
3105 W 5400 S Taylorsville UT 84129-2200 |
| Practice Telephone | 8019696236 |
| Practice Fax Number | 8019664572 |
| Mailing Telephone | 8019696236 |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2019-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
9015161-9922 | UT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 059339 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 391 N 400 E, Price, UT 845012537 | 4356372222 | 4356372228 |
| Street Address |
3105 W 5400 S |
| City | TAYLORSVILLE |
| State | UT |
| Zip Code | 84129-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790776920 | Mark Theodore Endrizzi | Dentist | 3105 W 5400 S, Taylorsville, UT 84118-2200 | 2005-11-05 |
| 1164580197 | Gerald Parker Poulsen | Dentist | 3105 W 5400 S, Taylorsville, UT 84118-2200 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891140331 | Caring for Kearns | Social Worker | 5525 S 4015 W, Suite #207 A & B, Taylorsville, UT 84129 | 2016-05-03 |
| 1386014116 | Rusty Scott Burns | Physician Assistant | 4745 South 3200 West, Oquirrh View Clinic, Taylorsville, UT 84129 | 2015-10-06 |
| 1013398817 | Clifford Simpson | Counselor | 4897 S Avant Cir, Taylorsville, UT 84129 | 2015-06-17 |
| 1912328576 | Heather Jenkins | Substance Abuse Rehabilitation Facility | 6200 South 3809 West, Kearns, UT 84129 | 2013-12-30 |
| 1184981201 | Intermountain Community Supports and Services, LLC | In Home Supportive Care | 5104 Heritage Cove, Taylorsville, UT 84129 | 2012-04-13 |
| 1093039521 | Chad Alan Spain | Family Medicine | 3745 West 4700 South, Family Practice, Taylorsville, UT 84129 | 2010-03-26 |
| 1396068342 | Lindsay Helena Wilson | Dermatology | 3845 West 4700 South, Intermountain Healthcare Taylorsville Clinic, Taylorsville, UT 84129 | 2010-03-04 |
| 1962962407 | Craig J Campbell Dpm PC | Durable Medical Equipment & Medical Supplies | 5255 S 4015 W, #140, Salt Lake City, UT 84129 | 2019-03-21 |
| 1851866735 | Katie Nicholls | Physician Assistant | 4745 S 3200 W, Taylorsville, UT 84129 | 2018-10-08 |
| 1962829374 | Spencer Tingey | Family Medicine | 3730 W 4700 S, Taylorsville, UT 84129 | 2014-03-24 |
| Find all providers in zip 84129 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134662752 | Small Smiles Dental, LLC | Dentist | 6087 S Redwood Rd Ste C, Taylorsville, UT 84123-6854 | 2016-11-30 |
| 1073841268 | James Wylie Thomas | Dentist | 2195 W 5400 S, Suite 203, Taylorsville, UT 84129-1431 | 2009-11-26 |
| 1104036557 | Brian William Baird | Dentist | 5547 S 4015 W, Suite #3, Taylorsville, UT 84118-4437 | 2007-05-23 |
| 1104955236 | Baird Orthodontics, PC | Dentist | 5547 S 4015 W, Suite 3, Taylorsville, UT 84118-4437 | 2007-03-05 |
| 1164580197 | Gerald Parker Poulsen | Dentist | 3105 W 5400 S, Taylorsville, UT 84118-2200 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100295 | Riley Hunsaker | Dentist | 10654 S River Heights Dr, South Jordan, UT 84095-5522 | 2020-10-09 |
| 1174132450 | Jason C Johnson | Dentist | 1231 W 9000 S., Suite #d, West Jordan, UT 84088-5176 | 2020-07-23 |
| 1346884335 | Orthodontics of St. George, P.C. | Dentist | 965 E 700 S Ste 101, St George, UT 84790-4084 | 2019-11-01 |
| 1063063105 | Abundant Dental Care, P.C. | Dentist | 641 W 9000 S Ste 2, Sandy, UT 84070-2580 | 2019-09-20 |
| 1366096208 | Hailee Rask | Dentist | 2255 N University Pkwy Ste 37, Provo, UT 84604-1503 | 2019-07-29 |
| 1477112779 | Alan Clawson Baugh | Dentist | 4019 W 12600 S Ste 210, Riverton, UT 84096-7407 | 2019-06-10 |
| 1821553785 | Raymond Scott Hlavaty | Dentist | 150 E 200 N Ste A, Logan, UT 84321-4036 | 2019-02-05 |
| 1235601659 | Burke and Beckstrom Orthodontics | Dentist | 446 S Mall Dr Ste 100, St George, UT 84790-4944 | 2018-12-24 |
| 1194294488 | Kent Joseph Baugh | Dentist | 164 E 5900 S Ste A109, Murray, UT 84107-7248 | 2018-11-16 |
| 1194201467 | Patrick Kunkel | Dentist | 12569 2700 W, #100, Riverton, UT 84065 | 2018-07-19 |
| Find all providers with the same taxonomy | ||||
| City | TAYLORSVILLE |
| Zip Code | 84129 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.