LCR DENTAL SUGAR HOUSE (NPI# 1518478742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518478742 |
| Entity Type | Organization |
| Organization Name | LCR DENTAL SUGAR HOUSE |
| Practice Address |
2068 S 2100 E Suite #a Salt Lake City UT 84108 |
| Mailing Address |
1409 W 1000 N Salt Lake City UT 84116 |
| Practice Telephone | 8015321402 |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2017-10-16 |
| Authorized Official Name | LAWRENCE CLARK ROMNEY (MANAGING MEMBER) |
| Authorized Official Telephone | 8015417787 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
2068 S 2100 E SUITE #A |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548753056 | Maxine Ht Erickson | Assistant Behavior Analyst | 780 Guardsman Way, Salt Lake City, Ut 84108, Salt Lake City, USA 84108 | 2018-06-08 |
| 1841704061 | Robyn Carver | Occupational Therapist | 421 Wakara Wat, Salt Lake City, UT 84108 | 2017-11-27 |
| 1447708912 | Aubrianne Squire Evans | Occupational Therapist | 421 S Wakara Way Ste 201, Salt Lake City, UT 84108 | 2016-09-14 |
| 1629524426 | Ryan Weisenbeck | Specialist/Technologist | 580 S Guardsman Way, Salt Lake City, UT 84108 | 2016-08-31 |
| 1164885547 | Michael Fazzone | Student in an Organized Health Care Education/Training Program | 530 South Wakara Way, University of Urah, School of Dentistry, Salt Lake City, UT 84108 | 2016-04-01 |
| 1669833489 | Bryon Claflin | Registered Nurse | 650 S Komas Ste 200, Salt Lake City, UT 84108 | 2016-03-08 |
| 1801283833 | Autism Assement Treatment Program Adult | Psychologist | 650 S Komas, Suite 200, Salt Lake City, UT 84108 | 2015-04-16 |
| 1578993275 | Matthew and David Dental Pllc | Dentist | 1355 Foothill Drive, Salt Lake City, UT 84108 | 2013-11-15 |
| 1841631520 | Deepika Garg | Internal Medicine | 675 S Arapeen Dr Ste 205, Salt Lake City, UT 84108 | 2013-07-10 |
| 1578817532 | Melissa Alder | Psychologist | 1300s 1709e, Suite 200, Salt Lake City, UT 84108 | 2012-10-30 |
| Find all providers in zip 84108 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1972954790 | Audrey Sill | Dentist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-06-22 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84108 |
Please comment or provide details below to improve the information on LCR DENTAL SUGAR HOUSE.
| 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.