Healthcare Provider Details

I. General information

NPI: 1245424498
Provider Name (Legal Business Name): RYAN SHANE DOWLING D.M.D.,M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 FORT UNION BLVD
SALT LAKE CITY UT
84121-3148
US

IV. Provider business mailing address

210 N 2475 W
PROVO UT
84601-2235
US

V. Phone/Fax

Practice location:
  • Phone: 801-944-4141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number11109
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: