MEDICARE: MICHAEL VAN LEEUWEN DMD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1380749922	UT

General Provider Information

NPI Number	:	1639242084
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL VAN LEEUWEN DMD PC

Provider Business Mailing Address
First Line	:	6936 SOUTH 2475 EAST
Second Line	:	SUITE 201
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121
Country	:	US
Telephone Number	:	801-943-1612
Fax Number	:	801-942-6008

Provider Business Practice Location Address
First Line	:	6936 SOUTH 2475 EAST
Second Line	:	SUITE 201
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121
Country	:	US
Telephone Number	:	801-943-1612
Fax Number	:	801-942-6008

Authorized Official
Title or Position	:	PRESIDENT DENTIST
Name	:	MR. MICHAEL LEE VAN LEEUWEN
Credential	:	DMD
Telephone Number	:	801-943-1612

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	01/27/2014

Similar Medicare Providers

1053885285 — REBECCA WHITAKER JACKSON
Practice Location Address:

2825 E COTTONWOOD PKWY STE 500
SALT LAKE CITY, UT
84121-7060

Practice Phone: 801-448-6195
Practice Fax:

1982131595 — DR. NICOLE KRISTINE HEWETT MD
Practice Location Address:

7138 S 2000 E STE 106
SALT LAKE CITY, UT
84121-3775

Practice Phone: 801-942-1800
Practice Fax: 801-944-1865

1508713173 — GILLIAN LORENC
Practice Location Address:

2825 E COTTONWOOD PKWY
SALT LAKE CITY, UT
84121-7055

Practice Phone: 801-448-6195
Practice Fax:

1619101144 — AUDREY LEAURO MAUSIA RN
Practice Location Address:

5965 S 900 E
SALT LAKE CITY, UT
84121-1720

Practice Phone: 801-963-4216
Practice Fax: 801-963-4299

1932059318 — OWEN FLEISHMAN
Practice Location Address:

6910 S HIGHLAND DR STE 1
SALT LAKE CITY, UT
84121-3061

Practice Phone: 801-935-4171
Practice Fax:

1073468997 — BRENDA S ARMSTRONG
Practice Location Address:

2825 COTTONWOOD PARKWAY
SALT LAKE CITY, UT
84121

Practice Phone: 801-448-6195
Practice Fax:

1649451642 — ERIC JOHN SCHMIDT MSSW, LCSW, MBA
Practice Location Address:

2450 E FT UNION BLVD
SALT LAKE CITY, UT
84121-3337

Practice Phone: 801-669-5888
Practice Fax: 801-669-5889

Directions to “MICHAEL VAN LEEUWEN DMD PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.