Healthcare Provider Details

I. General information

NPI: 1326976713
Provider Name (Legal Business Name): RAMIRO CANTU III DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7632 S CAMPUS VIEW DR STE 150
WEST JORDAN UT
84084-5545
US

IV. Provider business mailing address

4231 MADERO ST
RIO GRANDE CITY TX
78582-5023
US

V. Phone/Fax

Practice location:
  • Phone: 801-282-4142
  • Fax:
Mailing address:
  • Phone: 956-735-8274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14280160-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: