EDDIE FADDIS, DDS, PC (NPI# 1770842593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770842593 |
| Entity Type | Organization |
| Organization Name | EDDIE FADDIS, DDS, PC |
| Practice Address |
533 W State Rd Ste 202 Pleasant Grove UT 84062-2114 |
| Practice Telephone | 8017858835 |
| Practice Fax Number | 8017859629 |
| Mailing Telephone | 8017858835 |
| Mailing Fax Number | 8017859629 |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2015-12-11 |
| Authorized Official Name | EDDIE FADDIS (PRESIDENT) |
| Authorized Official Telephone | 8017858835 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
145625 | UT | Dental Providers |
| Street Address |
533 W STATE RD STE 202 |
| City | PLEASANT GROVE |
| State | UT |
| Zip Code | 84062-2114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285289835 | Sara Nicole Torsak | Behavior Technician | 533 W State Rd, Pleasant Grove, UT 84062-2114 | 2019-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467934406 | Welcome Home Assisted Living of American Fork | Assisted Living Facility | 1889 W 930 N, Pleasant Grove, UT 84062 | 2018-09-06 |
| 1497243414 | Doterra Employee Health Systems, LLC | Family Medicine | 1364 Pleasant Grove Blvd., Floor 3, Pleasant Grove, UT 84062 | 2018-04-25 |
| 1720588080 | Us Sports Medicine, LLC | Clinic/Center | 1982 W. Pleasant Grove Blvd, Suite L, Pleasant Grove, UT 84062 | 2018-02-13 |
| 1235669011 | Rapid Reboot Recovery Products LLC | Durable Medical Equipment & Medical Supplies | 1262 W 3150 N, Pleasant Grove, UT 84062 | 2017-06-14 |
| 1497126486 | Trumobility Inc. | Durable Medical Equipment & Medical Supplies | 272 S 671 W, Pleasant Grove, UT 84062 | 2015-10-15 |
| 1295146272 | North County Medical | Chiropractor | 1988 West 930 North Suite Number A, Pleasant Grove, UT 84062 | 2014-05-13 |
| 1861814493 | Trent Edwards | Case Manager/Care Coordinator | 365 West 1420 North, Pleasant Grove, UT 84062 | 2014-01-16 |
| 1013342690 | Michael M. Haderlie | Psychologist | 233 S. Pleasant Grove Blvd, Suite 203, Pleasant Grove, UT 84062 | 2013-09-13 |
| 1194157123 | Brianna Lastre | Nurse Practitioner | 1446 W Pleasant Grove Blvd., Pleasant Grove, UT 84062 | 2013-08-01 |
| 1356619266 | Melinda Buchanan-emery | Marriage & Family Therapist | 459 East 1000 South, Pleasant Grove, UT 84062 | 2011-12-06 |
| Find all providers in zip 84062 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144439191 | Kenneth T. Usry | Dentist | 717 1st Ter, Pleasant Grove, AL 35127-1848 | 2007-05-22 |
| 1710195466 | J Shane Roberts | Dentist | 904 4th St, Pleasant Grove, AL 35127-1059 | 2007-05-18 |
| 1326255993 | Gavin Trevor Smith | Dentist | 60 E State Rd, Pleasant Grove, UT 84062-2637 | 2007-05-16 |
| 1548475551 | Robert Reese Blackhurst | Dentist | 922 N 2000 W, Pleasant Grove, UT 84062-4047 | 2007-05-12 |
| 1023230570 | Rod P. Maxfield | Dentist | 31 W. 100 So., Suite A, Pleasant Grove, UT 84062 | 2007-05-03 |
| 1912032251 | William Fletcher Adamson | Dentist | 31 W 100 S Ste B, Pleasant Grove, UT 84062-2641 | 2007-02-23 |
| 1396886511 | Eddie S. Faddis | Dentist | 533 W State Rd Ste 202, Pleasant Grove, UT 84062-2116 | 2007-02-09 |
| 1558420349 | Arnoud Noot | Dentist | 1390 W State Rd, Suite 1, Pleasant Grove, UT 84062-4080 | 2006-12-07 |
| 1184792905 | Aaron H Jones | Dentist | 597 South Pleasant Grove Boulevard, Suite 12, Pleasant Grove, UT 84062-2161 | 2006-12-01 |
| 1659465086 | Steven F. Mciff | Dentist | 31 West 100 South, Suite C, Pleasant Grove, UT 84062-2641 | 2006-10-02 |
| Find all providers in PLEASANT GROVE | ||||
| City | PLEASANT GROVE |
| Zip Code | 84062 |
Please comment or provide details below to improve the information on EDDIE FADDIS, DDS, PC.
| 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.