Provider Demographics
NPI:1407917248
Name:CAHOON, KEVIN S (DDS)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:S
Last Name:CAHOON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-1718
Mailing Address - Country:US
Mailing Address - Phone:801-583-6358
Mailing Address - Fax:801-303-7055
Practice Address - Street 1:107 S 500 W
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2029
Practice Address - Country:US
Practice Address - Phone:801-583-6358
Practice Address - Fax:801-303-7055
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ68291223G0001X
CO97681223G0001X
UT139914-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice