SWAN PEDIATRIC DENTAL (NPI# 1841763513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841763513 |
| Entity Type | Organization |
| Organization Name | SWAN PEDIATRIC DENTAL |
| Practice Address |
601 N State Road 198 Salem UT 84653-4504 |
| Mailing Address |
1177 W 1960 N Pleasant Grove UT 84062-4039 |
| Practice Telephone | 8014237969 |
| Mailing Telephone | 8017188348 |
| Enumeration Date | 2019-01-06 |
| Last Update Date | 2019-01-06 |
| Authorized Official Name | DR. MATTHEW ALLEN SWAN (OWNER) |
| Authorized Official Telephone | 8017188348 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1336405315 | 05 |
| Other Name | Type Code |
|---|---|
| Salem Smiles | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 54 N Main St, Nephi, UT 846481402 | 4355805055 |
| Street Address |
601 N STATE ROAD 198 |
| City | SALEM |
| State | UT |
| Zip Code | 84653-4504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457759425 | Hulse Dentisry LLC | Clinic/Center | 601 N State Road 198, Salem, UT 84653-4504 | 2014-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487008603 | Douglas Robert Clark | Optometrist | 446 N State Road 198, Salem, UT 84653 | 2016-04-14 |
| 1811357791 | Melanie Pace | Dental Hygienist | 818 East 750 South, Salem, UT 84653 | 2016-03-04 |
| 1265773899 | Bill Clifford Marshall | Marriage & Family Therapist | 405 S Maple Dr, Woodland Hills, UT 84653 | 2013-03-06 |
| 1013159995 | Elder Assisted Living LLC | Assisted Living Facility | 1015 S 550 W, Salem, UT 84653 | 2009-03-24 |
| 1780884247 | David Kent Hansen | Dentist | 204 East 400 North, Suite A, Salem, UT 84653 | 2007-07-23 |
| 1154524965 | Justin Thomas Perry | Dentist | 40 South 200 West, Salem, UT 84653 | 2007-06-08 |
| 1013130947 | John E Braithwaite | Dentist | 40 S 200 W, Salem, UT 84653 | 2007-04-10 |
| 1104972827 | Salem City Corporation | Ambulance | 30 W 100 S, Salem, UT 84653 | 2007-01-26 |
| 1700989209 | James Bryan Bonny | Dentist | 245 W State Hwy 198, Suite 6, Salem, UT 84653 | 2006-09-07 |
| 1578574570 | Kids Who Count | Day Training, Developmentally Disabled Services | 345 N Sr 198, Salem, UT 84653 | 2006-08-11 |
| Find all providers in zip 84653 | ||||
| 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 |
|---|---|---|---|---|
| 1811557457 | Chadi Farag | Dentist | 25620 75th Street, Salem, WI 53168 | 2019-06-17 |
| 1528626660 | Stephanie Danielle Gibbons | Dentist | 5 Dawn St, Salem, NH 03079-3231 | 2019-06-04 |
| 1407414642 | Selma Moon Pierce | Dentist | 961 Glen Eden Ct Nw, Salem, OR 97304-2258 | 2019-06-03 |
| 1295392926 | Brock Jesse Nelson | Dentist | 631 Jason St Ne Ste 150, Salem, OR 97301-2750 | 2019-05-29 |
| 1023595899 | Gregory Lee Miller | Dentist | 3405 Derr Park Rd Se, Salem, OR 97310-0001 | 2018-07-25 |
| 1437643616 | Idylwood Dental LLC | Dentist | 4392 Liberty Road, Salem, OR 97302-6171 | 2018-06-20 |
| 1619428281 | William D. Bateman, Dmd, LLC | Dentist | 1995 Commercial St Se Ste 200, Salem, OR 97302-5291 | 2016-10-19 |
| 1134545494 | Caroline Wallace | Dentist | 103 S Colorado St, Salem, VA 24153-3848 | 2014-03-11 |
| 1275960296 | Amy Trevor | Dentist | 1595 Commercial St. Se, Salem, OR 97302 | 2013-10-04 |
| 1558601385 | Crisdental East Salem, LLC | Dentist | 3545 Lancaster Dr Ne, Salem, OR 97305-1435 | 2013-02-14 |
| Find all providers in SALEM | ||||
Please comment or provide details below to improve the information on SWAN PEDIATRIC DENTAL.
| 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.