CREEK CAPITAL VINE STREET LLC (NPI# 1154849081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154849081 |
| Entity Type | Organization |
| Organization Name | CREEK CAPITAL VINE STREET LLC |
| Other Organization Name | BURG CHILDREN'S DENTISTRY & ORTHODONTICS- VINE STREET |
| Practice Address |
678 E Vine St Ste 12 Murray UT 84107-5500 |
| Mailing Address |
678 E Vine St Ste 10 Murray UT 84107-5500 |
| Practice Telephone | 8012681135 |
| Practice Fax Number | 8012681135 |
| Mailing Telephone | 8013121722 |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2017-08-30 |
| Authorized Official Name | MARCI NICOL (COO) |
| Authorized Official Telephone | 8013121722 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Burg Children's Dentistry & Orthodontics- Vine Street | Doing Business As Name - Organization |
| Street Address |
678 E VINE ST STE 12 |
| City | MURRAY |
| State | UT |
| Zip Code | 84107-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790205789 | Kathryn Elizabeth Cameron | Dentist | 6065 S Fashion Blvd Ste 200, Murray, UT 84107-5406 | 2017-06-21 |
| 1477921419 | Murray Dental Care | Dentist | 793 E Winchester St, Murray, UT 84107-7564 | 2015-09-08 |
| 1730562141 | Megan Merica Snarr | Dentist | 597 West 5300 South, Murray, UT 84123 | 2015-07-02 |
| 1982084265 | Grant Heward | Dentist | 5630 S Waterbury Way, B201, Murray, UT 84121-1182 | 2015-06-02 |
| 1033532015 | Fashion Place Dental | Dentist | 6095 S Fashion Blvd Ste 290, Murray, UT 84107-7391 | 2014-01-28 |
| 1508084997 | Randall Keith Taylor | Dentist | 700 Whitnell St, Murray, KY 42071-2966 | 2007-04-23 |
| 1134263478 | Andrew Mark Smith | Dentist | 6040 Fashion Blvd Ste 100, Murray, UT 84107-5415 | 2007-02-19 |
| 1790882504 | George Coleman Oakley | Dentist | 1210 Johnson Blvd, Murray, KY 42071 | 2006-09-20 |
| 1457454084 | William Nall Pasco | Dentist | 1653 Calloway Ave, Murray, KY 42071 | 2006-09-07 |
| 1265548481 | Steven Edward Farmer | Dentist | 1711 St Rte 121 N, Murray, KY 42071 | 2006-08-21 |
| Find all providers in MURRAY | ||||
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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.