DR. KEITH J POULSEN (NPI# 1407970916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407970916 |
| Entity Type | Individual |
| Full Name | DR. KEITH J POULSEN |
| Credential | D.D.S |
| Practice Address |
7138 Highland Dr Suite 216 Salt Lake City UT 84121-3757 |
| Practice Telephone | 8019440668 |
| Practice Fax Number | 8019444482 |
| Mailing Telephone | 8019440668 |
| Mailing Fax Number | 8019444482 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
134901 | UT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225387129 | Keith Pappas Poulsen | Veterinarian | 700 Sw 30th St, Corvallis, OR 97331-8628 | 2012-09-06 |
| Street Address |
7138 HIGHLAND DR SUITE 216 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84121-3757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467466532 | Kent N Johnson | Dentist | 7138 Highland Dr, Suite 220, Salt Lake City, UT 84121-3757 | 2006-07-27 |
| 1821328501 | Steven B Lowe | Dentist | 7138 Highland Dr, Suite 212, Salt Lake City, UT 84121-3757 | 2010-01-03 |
| 1982873584 | Jon W Silcox | Dentist | 7138 Highland Dr, Suite 213, Salt Lake City, UT 84121-3757 | 2008-02-27 |
| 1598883050 | Evan M Roundy | Dentist | 7138 Highland Dr, Suite 215, Salt Lake City, UT 84121-3757 | 2007-03-26 |
| 1043224116 | Christopher S Johnson | Dentist | 7138 Highland Dr, Suite 220, Salt Lake City, UT 84121-3757 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518478742 | Lcr Dental Sugar House | Dentist | 2068 S 2100 E Suite #a, Salt Lake City, UT 84108 | 2017-10-16 |
| 1316465255 | Creek Capital Cottonwood LLC | Dentist | 7050 S Highland Dr Ste 110, Salt Lake City, UT 84121-3764 | 2017-08-30 |
| 1558777151 | Jami Ballantine | Dentist | 55 N Redwood Rd, Salt Lake City, UT 84116-3121 | 2014-07-03 |
| 1831338623 | Rose Park Pediatric Dentistry, PC | Dentist | 55 N Redwood Rd Ste B, Salt Lake City, UT 84116-3174 | 2009-02-18 |
| 1346366283 | Hans Christian Reinemer | Dentist | 1963 E 5600 S, Salt Lake City, UT 84121-1351 | 2007-03-22 |
| 1578612602 | Debbie Lee Graham | Dentist | 620 E 2100 S, Salt Lake City, UT 84106-1828 | 2007-01-09 |
| 1720149453 | Jeffery K. Rupp | Dentist | 1548 E 4500 S, Suite 102, Salt Lake City, UT 84117-4209 | 2006-12-13 |
| 1982670568 | Val Joseph Cheever | Dentist | 1955 S 1300 E, Salt Lake City, UT 84105-3638 | 2006-02-24 |
| 1316438310 | Justin Moody | Dentist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2018-05-24 |
| 1346761152 | Walker Dean Clark | Dentist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2017-06-30 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84121 |
Please comment or provide details below to improve the information on DR. KEITH J POULSEN.
| 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.