Provider Demographics
NPI:1326690017
Name:VINEYARD HEIGHTS DENTAL LLC
Entity Type:Organization
Organization Name:VINEYARD HEIGHTS DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CARVER
Authorized Official - Last Name:STANDRING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-901-3736
Mailing Address - Street 1:707 E MILL RD STE 302
Mailing Address - Street 2:
Mailing Address - City:VINEYARD
Mailing Address - State:UT
Mailing Address - Zip Code:84059-5729
Mailing Address - Country:US
Mailing Address - Phone:801-901-3736
Mailing Address - Fax:385-283-0660
Practice Address - Street 1:707 E MILL RD STE 302
Practice Address - Street 2:
Practice Address - City:VINEYARD
Practice Address - State:UT
Practice Address - Zip Code:84059-5729
Practice Address - Country:US
Practice Address - Phone:801-901-3736
Practice Address - Fax:385-283-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty