Healthcare Provider Details

I. General information

NPI: 1144077405
Provider Name (Legal Business Name): TARALYN MEINZER RDH, OMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 CAMBRIA DR
NORTH SALT LAKE UT
84054-5010
US

IV. Provider business mailing address

1034 CAMBRIA DR
NORTH SALT LAKE UT
84054-5010
US

V. Phone/Fax

Practice location:
  • Phone: 801-979-4266
  • Fax:
Mailing address:
  • Phone: 801-979-4266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number5359583-9920
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: