BULLEN & WILSON EAGLEGATE COLLEGE DENTAL CLINIC (NPI# 1962635466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962635466 |
| Entity Type | Organization |
| Organization Name | BULLEN & WILSON EAGLEGATE COLLEGE DENTAL CLINIC |
| Practice Address |
5618 Green St Murray UT 84123-5796 |
| Practice Telephone | 8013338138 |
| Practice Fax Number | 8012636520 |
| Mailing Telephone | 8013338138 |
| Mailing Fax Number | 8012636520 |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2009-08-31 |
| Authorized Official Name | MS. HOLLI D STEWART (CLINIC MANAGER) |
| Authorized Official Telephone | 8013338138 |
| Authorized Official Credential | CDA |
| Is Organization Subpart | Y |
| Parent Organization Name | BULLEN & WILSON EAGLEGATE COLLEGE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
133186-9922 | UT | Dental Providers |
| Street Address |
5618 GREEN ST |
| City | MURRAY |
| State | UT |
| Zip Code | 84123-5796 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679186837 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5792 South Redwood Road, Taylorsville, UT 84123 | 2020-08-27 |
| 1164040614 | Mark E Hutchinson | Counselor | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| 1396259321 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4082 South Redwood Road, West Valley Road, UT 84123 | 2017-11-29 |
| 1083131890 | Kelli Mcstotts | Counselor | 5689 S. Redwood Road, Taylorsville, UT 84123 | 2017-08-23 |
| 1740706571 | Laura B Ellsworth | Case Manager/Care Coordinator | 5667 So. Redwood Road, 6b, Salt Lake City, UT 84123 | 2017-08-14 |
| 1790214120 | Integrated Autism Therapies | Behavioral Analyst | 5984 S. Susquehanna, Murray, UT 84123 | 2017-06-08 |
| 1083163885 | Michael John Flint | Counselor | 5861 South Redwood Road, #24, Taylorsville, UT 84123 | 2016-09-22 |
| 1548716236 | Andres Ramos | Licensed Psychiatric Technician | 697 West 4170 South, Murray, UT 84123 | 2016-09-01 |
| 1467807040 | Sheryl R Schindler | Counselor | 5770 South 1550 West, Bldg G, Primary Children's Counseling Center, Taylorsville, UT 84123 | 2016-05-02 |
| 1730562141 | Megan Merica Snarr | Dentist | 597 West 5300 South, Murray, UT 84123 | 2015-07-02 |
| Find all providers in zip 84123 | ||||
| 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 |
|---|---|---|---|---|
| 1205335346 | Elevation Dentistry Pllc | Dentist | 1710 Hwy 121 N. Byp. Ste A, Murray, KY 42071 | 2018-02-05 |
| 1396263232 | Creek Capital Burg General LLC | Dentist | 678 E Vine St Ste 10, Murray, UT 84107-5500 | 2017-08-30 |
| 1124477294 | Jason Wareham | Dentist | 6040 S Fashion Blvd Ste 100, Murray, UT 84107 | 2016-06-08 |
| 1225437353 | Access Professional Dental Care,llc | Dentist | 6540 S State St, Murray, UT 84107-7219 | 2014-08-14 |
| 1467719674 | Anna Jayjock | Dentist | 700 Whitnell Avenue, Murray, KY 42071 | 2012-04-12 |
| 1609020478 | Randy N. Downing | Dentist | 6095 S Fashion Blvd Ste 200, Murray, UT 84107-7395 | 2008-11-06 |
| 1770740458 | George Winder | Dentist | 1035 Bellwood Ln, Suite 100, Murray, UT 84123-7964 | 2008-05-20 |
| 1598943136 | Morgan Jay Smith | Dentist | 6065 Fashion Blvd Ste 200, Murray, UT 84107-5406 | 2008-02-06 |
| 1902008378 | John Hicks Middleton | Dentist | 4970 S 900 E Ste E, Murray, UT 84117-5796 | 2007-06-05 |
| 1619183357 | John William Myers | Dentist | 6095 Fashion Blvd Ste 290, Murray, UT 84107-7391 | 2007-05-16 |
| Find all providers in MURRAY | ||||
Please comment or provide details below to improve the information on BULLEN & WILSON EAGLEGATE COLLEGE DENTAL CLINIC.
| 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.