Provider Demographics
NPI:1982038154
Name:NEWLAND, TANNON DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:TANNON
Middle Name:DAVID
Last Name:NEWLAND
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 GREENBELT CIR
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-8514
Mailing Address - Country:US
Mailing Address - Phone:801-232-8191
Mailing Address - Fax:
Practice Address - Street 1:700 N FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2728
Practice Address - Country:US
Practice Address - Phone:801-444-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8738022-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist