Healthcare Provider Details

I. General information

NPI: 1144858234
Provider Name (Legal Business Name): REBECCA ARIANNE SCHNEIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 W 400 S
SALT LAKE CITY UT
84101-1135
US

IV. Provider business mailing address

409 W 400 S
SALT LAKE CITY UT
84101-1135
US

V. Phone/Fax

Practice location:
  • Phone: 801-364-0058
  • Fax:
Mailing address:
  • Phone: 801-364-0058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12302693-9923
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: