SG DENTAL PLLC (NPI# 1831721240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831721240 |
| Entity Type | Organization |
| Organization Name | SG DENTAL PLLC |
| Practice Address |
225 Skyhawk Dr Wendover UT 84083-4501 |
| Mailing Address |
5778 W 6200 S Kearns UT 84118-7928 |
| Practice Telephone | 8017186881 |
| Mailing Telephone | 8017186881 |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-02-05 |
| Authorized Official Name | DR. JAMES SPENCER GRUBER (DENTIST) |
| Authorized Official Telephone | 8017186881 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bonneville Dental | Doing Business As Name - Organization |
| Street Address |
225 SKYHAWK DR |
| City | WENDOVER |
| State | UT |
| Zip Code | 84083-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447340799 | Wendover Eye Care, Inc | Optometrist | 479 E Wendover Blvd, Wendover, UT 84083 | 2006-10-14 |
| 1457389843 | Wendover Eyecare | Optometrist | 479 E. Wendover Blvd., Wendover, UT 84083 | 2006-06-28 |
| 1376575613 | D Craig Chamberlain | Dentist | 399 N Aria Blvd, Wendover, UT 84083-0625 | 2006-07-07 |
| 1992119622 | Wendover Dental Care PC | Dentist | 399 N Aria Blvd, Wendover, UT 84083-0625 | 2014-06-20 |
| 1457368656 | Kerry M. Winkel | Dentist | 225 Skyhawk Dr., Wendover, UT 84083-1216 | 2006-08-01 |
| 1508349499 | Mcconnell Dental Care II | Dentist | 399 Aria Blvd, Wendover, UT 84083-4550 | 2018-09-07 |
| 1255442885 | Scott Allen | Optometrist | 393 Aria Blvd, Wendover, UT 84083-4550 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508349499 | Mcconnell Dental Care II | Dentist | 399 Aria Blvd, Wendover, UT 84083-4550 | 2018-09-07 |
| 1417488396 | Kimberlee Haycock | Behavior Technician | 1417 Cactus St, Wendover, NV 89883-3030 | 2017-03-23 |
| 1891877734 | State of Nevada | Clinic/Center | 925 Wells Ave, Wendover, NV 89883 | 2006-10-19 |
| 1447340799 | Wendover Eye Care, Inc | Optometrist | 479 E Wendover Blvd, Wendover, UT 84083 | 2006-10-14 |
| 1255442885 | Scott Allen | Optometrist | 393 Aria Blvd, Wendover, UT 84083-4550 | 2006-08-31 |
| 1457368656 | Kerry M. Winkel | Dentist | 225 Skyhawk Dr., Wendover, UT 84083-1216 | 2006-08-01 |
| 1396760914 | Smiths Food & Drug Centers Inc | Durable Medical Equipment & Medical Supplies | 1855 West Wendover Blvd, Wendover, NV 89883 | 2006-07-13 |
| 1376575613 | D Craig Chamberlain | Dentist | 399 N Aria Blvd, Wendover, UT 84083-0625 | 2006-07-07 |
| 1457389843 | Wendover Eyecare | Optometrist | 479 E. Wendover Blvd., Wendover, UT 84083 | 2006-06-28 |
| 1992119622 | Wendover Dental Care PC | Dentist | 399 N Aria Blvd, Wendover, UT 84083-0625 | 2014-06-20 |
| Find all providers in WENDOVER | ||||
| 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 |
| 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 |
| 1407490402 | Accessible Dental LLC | Clinic/Center | 1236 E Cedar Ridge Rd, Sandy, UT 84094-5603 | 2019-11-01 |
| Find all providers with the same taxonomy | ||||
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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.