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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
OASIS AESTHETICS | Doing Business As Name - Organization |
Street Address |
446 S MALL DR STE 1 |
City | ST GEORGE |
State | UT |
Zip Code | 84790-4944 |
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 |
Find all providers in zip 84790 |
Taxonomy Code | 261QM2500X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Medical Specialty |
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] |
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 |
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 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on DESERT BLOOM PLASTIC SURGERY LLC.
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.