KIDS TOWN PEDIATRIC DENTISTRY OF SYRACUSE (NPI# 1992179964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992179964 |
| Entity Type | Organization |
| Organization Name | KIDS TOWN PEDIATRIC DENTISTRY OF SYRACUSE |
| Practice Address |
780 S 2000 W Suite #f-2 Syracuse UT 84075-9602 |
| Practice Telephone | 8017768176 |
| Practice Fax Number | 8017749085 |
| Mailing Telephone | 8017768176 |
| Mailing Fax Number | 8017749085 |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2015-11-13 |
| Authorized Official Name | BRETT PACKHAM (MEMBER) |
| Authorized Official Telephone | 8012173359 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
6362621-9922 | UT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1477728269 | 05 |
| Street Address |
780 S 2000 W SUITE #F-2 |
| City | SYRACUSE |
| State | UT |
| Zip Code | 84075-9602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235247438 | Brett R Coleman | Dentist | 780 S 2000 W, Bldg E304, Syracuse, UT 84075 | 2006-08-28 |
| 1689116014 | Argyle Dental, PC | Clinic/Center | 780 S 2000 W, Suite E-301, Syracuse, UT 84075-9602 | 2016-11-16 |
| 1184998924 | Christine S Peasley | Social Worker | 780 S 2000 W, Suite E 302, Syracuse, UT 84075-9602 | 2012-02-24 |
| 1275805509 | Trampas J Rowden | Counselor | 780 S 2000 W, Building E, Suite #302, Syracuse, UT 84075-9602 | 2012-02-02 |
| 1871817940 | Rocky Mountain Wellness Center, LLC | Chiropractor | 780 S 2000 W, Bldg A, Ste. 101, Syracuse, UT 84075-9602 | 2010-03-18 |
| 1871730267 | William Green | Chiropractor | 780 S 2000 W, Bldg. A Suite 101, Syracuse, UT 84075-9602 | 2009-01-07 |
| 1982739249 | Richard A Ingram | Dentist | 780 S 2000 W, F 1, Syracuse, UT 84075-9602 | 2007-02-23 |
| 1154456010 | Shad T Ingram | Dentist | 780 S 2000 W, F 1, Syracuse, UT 84075-9602 | 2007-02-22 |
| 1801921804 | Clive C Ingram | Dentist | 780 S 2000 W, F 1, Syracuse, UT 84075-9602 | 2007-02-22 |
| 1396880134 | Jaren C. Argyle | Dentist | 780 S 2000 W, Suite E-301, Syracuse, UT 84075-9602 | 2007-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750775235 | Syracuse Assisted Living Phase I | Assisted Living Facility | 2063 W. 1900 S., Syracuse, UT 84075 | 2015-03-24 |
| 1881975464 | Norman Kent Sharp II | Dentist | 1662 S 2000 W Ste A1, Syracuse, UT 84075 | 2011-09-08 |
| 1245471705 | Ihc Health Services Inc | Family Medicine | 745 South 2000 West, Syracuse, UT 84075 | 2009-03-13 |
| 1124240197 | Richard Jackson | Psychologist | 2650 West 2700 South, Syracuse, UT 84075 | 2007-05-02 |
| 1679799902 | Nathan Wesley Elmore | Chiropractor | 1842 South 2000 West, Syracuse, UT 84075 | 2007-04-17 |
| 1972635332 | Aspen Institute for Behavioral Assessment | Psychiatric Residential Treatment Facility | 2732 W 2700 S, Syracuse, UT 84075 | 2007-03-12 |
| 1427111558 | Sheldon L Peck | Dentist | 1747 S Heritage Lane, Suite A3, Syracuse, UT 84075 | 2006-12-19 |
| 1811081771 | Tyler R Elmore | Chiropractor | 1013 W 2700 S, Syracuse, UT 84075 | 2006-10-03 |
| 1164431177 | Kipton Jay Norris | Dentist | 1747 S. Heritage Ln, Suite B-201, Syracuse, UT 84075 | 2006-08-07 |
| 1619982303 | Newell Taft | Counselor | 2512 West 1700 South, Syracuse, UT 84075 | 2006-07-30 |
| Find all providers in zip 84075 | ||||
| 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 |
|---|---|---|---|---|
| 1760850523 | Gary Wall | Dentist | 780 S 2000 W Ste F2, Syracuse, UT 84075-9609 | 2015-09-10 |
| 1811269756 | Pacific West Dental Group | Dentist | 1792 W 1700 S Ste 101, Syracuse, UT 84075-9650 | 2012-02-08 |
| 1750519864 | Tansy Schoonmaker | Dentist | 301 Prospect Ave, Pob Ste 705, Syracuse, NY 13203-1807 | 2009-06-26 |
| 1497945711 | Steve Hibbert | Dentist | 1747 Heritage Ln, Ste B202, Syracuse, UT 84075-8552 | 2007-08-01 |
| 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 |
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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.