Healthcare Provider Details

I. General information

NPI: 1659296986
Provider Name (Legal Business Name): DR. URBAN FACIAL SURGICAL ARTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7532 S CENTER VIEW CT STE 102
WEST JORDAN UT
84084-5547
US

IV. Provider business mailing address

7532 S CENTER VIEW CT STE 102
WEST JORDAN UT
84084-5547
US

V. Phone/Fax

Practice location:
  • Phone: 801-282-5363
  • Fax: 801-282-5360
Mailing address:
  • Phone: 801-282-5363
  • Fax: 801-282-5360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHELE URBAN
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 801-282-5363