MR. TRACE MICHAEL LUND (NPI# 1912072620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912072620 |
| Entity Type | Individual |
| Full Name | MR. TRACE MICHAEL LUND |
| Credential | DDS |
| Practice Address |
745 North 500 West Suite 103 Provo UT 84601 |
| Practice Telephone | 8013734200 |
| Practice Fax Number | 8013730816 |
| Mailing Telephone | 8013734200 |
| Mailing Fax Number | 8013730816 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
344947-8903 | UT | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
344947-9922 | UT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386201887 | Trace W Lund | Case Manager/Care Coordinator | 4460 S Highland Dr, Salt Lake City, UT 84124-3543 | 2019-05-21 |
| Street Address |
745 NORTH 500 WEST SUITE 103 |
| City | PROVO |
| State | UT |
| Zip Code | 84601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598830291 | Kevin Richard Markham | Dentist | 745 North 500 West, Suite 103, Provo, UT 84601 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
| 1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| 1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
| 1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
| Find all providers in zip 84601 | ||||
| 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 |
|---|---|---|---|---|
| 1811446727 | Bryce John Bott | Dentist | 745 N 500 W Ste 103, Provo, UT 84601-1475 | 2016-10-03 |
| 1821093048 | Donald Ray Gifford | Dentist | 2230 N University Pkwy, 8-b, Provo, UT 84604-1509 | 2005-06-15 |
| 1760828834 | John Ryan Blankenship | Dentist | 2230 N University Pkwy, Provo, UT 84604-1509 | 2013-05-16 |
| 1598830291 | Kevin Richard Markham | Dentist | 745 North 500 West, Suite 103, Provo, UT 84601 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891462 | South Davis Pediatric Dentistry LLC | Dentist | 59 W Pages Ln Ste 110, Bountiful, UT 84010-5988 | 2020-11-02 |
| 1376176198 | Happy Tooth Pediatric Dentistry, LLC | Dentist | 2453 E 3300 S, Millcreek, UT 84109-2725 | 2020-02-20 |
| 1750932273 | Michael R. Brown Dds Ms | Dentist | 1240 E 100 S Ste 120, St George, UT 84790-3079 | 2019-09-25 |
| 1609438357 | Children's Landing Pediatric Dentistry, PC | Dentist | 3855 W 7800 S Ste 200, West Jordan, UT 84088-5563 | 2019-07-02 |
| 1841766821 | Dry Creek Pediatric Dentistry | Dentist | 3300 N Running Creek Way F101, Lehi, UT 84043 | 2018-10-17 |
| 1639654684 | Clubhouse Pediatric Dentistry of West Jordan | Dentist | 1108 E South Union Ave, Midvale, UT 84047-2904 | 2018-09-26 |
| 1639667801 | St. George Kids Dental At Snow Canyon | Dentist | 1100 Canyon View Dr Ste A, Santa Clara, UT 84765-5672 | 2018-04-24 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1013420553 | Kevin Brown Dmd, LLC | Dentist | 1030 S 1100 W, Suite B, Lehi, UT 84043 | 2017-11-07 |
| 1518478742 | Lcr Dental Sugar House | Dentist | 2068 S 2100 E Suite #a, Salt Lake City, UT 84108 | 2017-10-16 |
| 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.