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Contact Information

INTERMOUNTAIN DENTAL SPECIALISTS
2797 N HIGHWAY 89
SUITE 200
PLEASANT VIEW, UT84404-1216
 Phone: 801-782-5682
 Fax: 801-786-0520
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthodontics and Dentofacial Orthopedics

1223X0400X
 

Endodontics

1223E0200X
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
 

Periodontics

1223P0300X
Indicates primary specialty

NPI Profile & details for INTERMOUNTAIN DENTAL SPECIALISTS

NPI # 1881069177
LBN Legal business name INTERMOUNTAIN DENTAL SPECIALISTS
Authorized official VICKI LEWIS - (SPECIALIST COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 12/11/2015
Last updated 12/11/2015 - About 10 years ago
Identifiers
UT License # 137712-9922
UT License # 145288-9922
UT License # 145326-9922
UT License # 8041458
UT License # 8598613-9924
UT License # 9371431-9921
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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