Healthcare Provider Details

I. General information

NPI: 1285574533
Provider Name (Legal Business Name): NOMAD DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2858 KIESEL AVE
OGDEN UT
84401-4218
US

IV. Provider business mailing address

2858 KIESEL AVE
OGDEN UT
84401-4218
US

V. Phone/Fax

Practice location:
  • Phone: 385-300-2905
  • Fax:
Mailing address:
  • Phone: 385-300-2905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH WILLIAM LANGFORD
Title or Position: DENTAL HYGENIST
Credential: RDH
Phone: 385-300-2905