KIDS CREEK PED. DENTISTRY (NPI# 1821521485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821521485 |
| Entity Type | Organization |
| Organization Name | KIDS CREEK PED. DENTISTRY |
| Practice Address |
2964 W 4700 S Ste 103 Taylorsville UT 84129-2558 |
| Practice Telephone | 8014178080 |
| Mailing Telephone | 8014178080 |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |
| Authorized Official Name | SAMUEL B BAILEY (OWNER) |
| Authorized Official Telephone | 8014178080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
7693653 | UT | Dental Providers |
| Street Address |
2964 W 4700 S STE 103 |
| City | TAYLORSVILLE |
| State | UT |
| Zip Code | 84129-2558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285990978 | Samuel Blackham Bailey | Dentist | 2964 W 4700 S Ste 103, Taylorsville, UT 84129-2558 | 2012-04-06 |
| 1215322029 | John Reimschiissel | Dentist | 2964 W 4700 S Ste 103, Taylorsville, UT 84129-2558 | 2015-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891140331 | Caring for Kearns | Social Worker | 5525 S 4015 W, Suite #207 A & B, Taylorsville, UT 84129 | 2016-05-03 |
| 1386014116 | Rusty Scott Burns | Physician Assistant | 4745 South 3200 West, Oquirrh View Clinic, Taylorsville, UT 84129 | 2015-10-06 |
| 1013398817 | Clifford Simpson | Counselor | 4897 S Avant Cir, Taylorsville, UT 84129 | 2015-06-17 |
| 1912328576 | Heather Jenkins | Substance Abuse Rehabilitation Facility | 6200 South 3809 West, Kearns, UT 84129 | 2013-12-30 |
| 1184981201 | Intermountain Community Supports and Services, LLC | In Home Supportive Care | 5104 Heritage Cove, Taylorsville, UT 84129 | 2012-04-13 |
| 1093039521 | Chad Alan Spain | Family Medicine | 3745 West 4700 South, Family Practice, Taylorsville, UT 84129 | 2010-03-26 |
| 1396068342 | Lindsay Helena Wilson | Dermatology | 3845 West 4700 South, Intermountain Healthcare Taylorsville Clinic, Taylorsville, UT 84129 | 2010-03-04 |
| 1962962407 | Craig J Campbell Dpm PC | Durable Medical Equipment & Medical Supplies | 5255 S 4015 W, #140, Salt Lake City, UT 84129 | 2019-03-21 |
| 1851866735 | Katie Nicholls | Physician Assistant | 4745 S 3200 W, Taylorsville, UT 84129 | 2018-10-08 |
| 1962829374 | Spencer Tingey | Family Medicine | 3730 W 4700 S, Taylorsville, UT 84129 | 2014-03-24 |
| Find all providers in zip 84129 | ||||
| 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 |
|---|---|---|---|---|
| 1619354271 | Redwood Pediatric Dentistry | Dentist | 6287 S Redwood Road #201, Taylorsville, UT 84123-6655 | 2015-05-04 |
| 1285990978 | Samuel Blackham Bailey | Dentist | 2964 W 4700 S Ste 103, Taylorsville, UT 84129-2558 | 2012-04-06 |
| 1194331785 | Utah Smile Clinic | Dentist | 6321 S Redwood Rd Ste 206, Taylorsville, UT 84123-6972 | 2020-09-18 |
| 1770191421 | Amy Ann Kinlaw Dmd Pllc | Dentist | 167 1st Ave Sw, Taylorsville, NC 28681-2639 | 2020-07-20 |
| 1215322029 | John Reimschiissel | Dentist | 2964 W 4700 S Ste 103, Taylorsville, UT 84129-2558 | 2015-03-30 |
| 1588720304 | Jason J Horgesheimer | Dentist | 6287 S Redwood Rd, Suite 201, Taylorsville, UT 84123-6634 | 2006-12-28 |
| 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 | ||||
| City | TAYLORSVILLE |
| Zip Code | 84129 |
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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.