Provider Demographics
NPI:1740341007
Name:GEHRING, DAREN FRED (DDS)
Entity type:Individual
Prefix:DR
First Name:DAREN
Middle Name:FRED
Last Name:GEHRING
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 1:3297 N 1450 E
Mailing Address - Street 2:
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-6756
Mailing Address - Country:US
Mailing Address - Phone:435-753-3574
Mailing Address - Fax:
Practice Address - Street 1:1624 N 200 E STE 100
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-3141
Practice Address - Country:US
Practice Address - Phone:435-752-4330
Practice Address - Fax:435-752-6330
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT28494699231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY119125000Medicaid
ID806491800Medicaid
UT71897Medicare UPIN
UT320053461Medicare UPIN
GA320043561Medicare UPIN
UT869042Medicare UPIN
ID806491800Medicaid
UT0284946990001Medicare UPIN
KY7962440Medicare UPIN
PA1439958Medicare UPIN
TX320053461Medicare UPIN