SIMPLY WISDOM TEETH PLLC (NPI# 1255857728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255857728 |
| Entity Type | Organization |
| Organization Name | SIMPLY WISDOM TEETH PLLC |
| Practice Address |
352 E Riverside Dr Ste A9 Saint George UT 84790-5812 |
| Practice Telephone | (435) 652-1243 |
| Practice Fax Number | 4356521243 |
| Mailing Telephone | 4356521243 |
| Mailing Fax Number | 4356521243 |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2017-08-16 |
| Authorized Official Name | MR. NIELS HENDRICKSON (MANAGER) |
| Authorized Official Telephone | 4352156621 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
143297 | UT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 528948205 | 05 |
| Street Address |
352 E RIVERSIDE DR STE A9 |
| City | SAINT GEORGE |
| State | UT |
| Zip Code | 84790-5812 |
| 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 | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609015 | Corner Clinic Dental Stg | Clinic/Center | 2351 S River Rd Ste 4, St George, UT 84790-8749 | 2020-11-04 |
| 1124637665 | Pony Express Dental of Saratoga Springs | Clinic/Center | 2253 S. Talons Cove Drive, Saratoga Springs, UT 84045-8400 | 2020-07-30 |
| 1154947372 | Preston G. Hansen, Dds, Pllc | Clinic/Center | 7138 S Highland Dr Ste 211, Salt Lake City, UT 84121-3787 | 2020-06-23 |
| 1114549573 | Richfield Family Dental | Clinic/Center | 820 N Main St Ste 1, Richfield, UT 84701-1893 | 2020-05-08 |
| 1639790918 | Nic-utah County, LLC | Clinic/Center | 2230 N University Pkwy Ste 8b, Provo, UT 84604-6700 | 2020-04-28 |
| 1063032225 | Haven Dental LLC | Clinic/Center | 2685 N 1000 W, Pleasant View, UT 84414-2660 | 2020-04-17 |
| 1972139681 | Kayscreek Dental Pllc | Clinic/Center | 349 N Flint St, Kaysville, UT 84037-9807 | 2020-03-14 |
| 1831721240 | Sg Dental Pllc | Clinic/Center | 225 Skyhawk Dr, Wendover, UT 84083-4501 | 2020-02-05 |
| 1740829993 | V and S Dental LLC | Clinic/Center | 3816 W 13400 S Ste 200, Riverton, UT 84065-7888 | 2020-01-04 |
| 1124664834 | Simply Smiles Dental Utah | Clinic/Center | 2592 S 5600 W Ste 102, West Valley City, UT 84120-1274 | 2019-11-18 |
| Find all providers with the same taxonomy | ||||
| City | SAINT GEORGE |
| Zip Code | 84790 |
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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.