Provider Demographics
NPI:1609020478
Name:DOWNING, RANDY N (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:N
Last Name:DOWNING
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 1:10970 S SECRET VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-4949
Mailing Address - Country:US
Mailing Address - Phone:801-262-4662
Mailing Address - Fax:
Practice Address - Street 1:6095 S FASHION BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7395
Practice Address - Country:US
Practice Address - Phone:801-262-4662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2015-03-30
Deactivation Date:2009-03-17
Deactivation Code:
Reactivation Date:2014-10-07
Provider Licenses
StateLicense IDTaxonomies
UT1420721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice