Healthcare Provider Details

I. General information

NPI: 1912830662
Provider Name (Legal Business Name): SUNNY SMILES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 E 12300 S # 8
DRAPER UT
84020-9503
US

IV. Provider business mailing address

3225 E 3900 S
SALT LAKE CITY UT
84124-2145
US

V. Phone/Fax

Practice location:
  • Phone: 801-553-2588
  • Fax:
Mailing address:
  • Phone: 801-888-5418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: KIM-LOAN NGUYEN
Title or Position: OWNER
Credential: DDS
Phone: 801-888-5418