DESERT BLOOM PLASTIC SURGERY LLC


Address: 446 S Mall Dr Ste 1, St George, UT 84790-4944
Phone: 4356278150

DESERT BLOOM PLASTIC SURGERY LLC (NPI# 1235691510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235691510
Entity Type Organization
Organization Name DESERT BLOOM PLASTIC SURGERY LLC
Practice Address 446 S Mall Dr Ste 1
St George
UT 84790-4944
Practice Telephone 4356278150
Mailing Telephone 4356278150
Enumeration Date 2019-04-04
Last Update Date 2019-04-04
Authorized Official Name JORDAN WALLIN (PRESIDENT)
Authorized Official Telephone 3365298744
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM2500X Clinic/Center
Specialization: Medical Specialty
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
OASIS AESTHETICS Doing Business As Name - Organization

Office Location

Street Address 446 S MALL DR STE 1
City ST GEORGE
State UT
Zip Code 84790-4944

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396342713 Katrina Poulsen Student in an Organized Health Care Education/Training Program 617 East Rriverside Dr, Ste 301, St. George, UT 84790 2020-10-08
1124643226 Desert View Eyecare Optometrist 15 South River Road St. 150, St. George, UT 84790 2020-06-15
1366066417 Benjamin Todd Lloyd Dentist 1683 E. Wolf Hole Dr, St. George, UT 84790 2020-06-04
1801434584 Jennifer M Putnam Marriage & Family Therapist 321 North Mall Drive, Vw103, St. George, UT 84790 2019-12-12
1326683012 Red Mountain Counseling and Education Counselor 321 No Mall Dr, Vw 103, St. George, UT 84790 2019-11-17
1295376002 Karynne Kimberly Simpson Behavior Technician 280 N 1680 E U1, St. George, UT 84790 2019-10-02
1962053017 Mikala Larsen Nurse Practitioner 1380 S Medical Center Dr., Saint George, UT 84790 2019-09-20
1326690678 Joe Ballent Student in an Organized Health Care Education/Training Program 1526 S Medical Center Dr Ste 224a, St George, UT 84790 2019-07-16
1558923854 David Pace Optometrist 749 South River Rd, St. George, UT 84790 2019-07-08
1639734924 Mariah Ann Mertlich Behavioral Analyst 280 N 1680 E, U1, St. George, UT 84790 2019-05-02
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Taxonomy Information

Taxonomy Code 261QM2500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Medical Specialty

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1508862947 Dixie Surgery Center, Inc Clinic/Center 1085 S Bluff St, St George, UT 84770-5245 2005-06-21
1780214734 Dixie Palliative Care, LLC Clinic/Center 352 E Riverside Dr Ste B3b, St George, UT 84790-5808 2020-01-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1417596339 Adams Chiropractic Inc. Clinic/Center 3336 S Pioneer Pkwy Ste 202, West Valley City, UT 84120-2080 2019-12-23
1720629371 Own My Health Medical Clinic/Center 12371 900 E, Suite 102, Draper, UT 84020 2019-10-04
1497316905 The West Clinic Draper Clinic/Center 12371 S 900 E, Draper, UT 84020-9833 2019-06-25
1568952190 Bear River Valley Medical LLC Clinic/Center 9825 N 10800 W, Tremonton, UT 84337-9222 2018-05-18
1376944942 Legacy Dermatology Clinic/Center 320 W 500 S, Suite 210, Bountiful, UT 84010-7218 2014-09-14
1821417684 James E Wellman Md Clinic/Center 5998 Spring Canyon Rd, Ogden, UT 84403-5476 2014-04-09
1255769386 Slc Diagnostic Imaging Clinic/Center 6202 W Freedom Hill Way, Herriman, UT 84096-6987 2013-10-29
1013269406 Cnm Clinic/Center 4749 S Holladay Blvd, Holladay, UT 84117-5420 2012-10-09
1023381241 Clifford G Harman Clinic/Center 12091 Lampton View Dr, Riverton, UT 84065-7834 2012-02-18
1386814168 Seeholzer Vision Center, Inc Clinic/Center 124 N Main Street, Logan, UT 84321 2008-03-07
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Competitor

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City ST GEORGE
Zip Code 84790

Improve Information

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Dataset Information

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.

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