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General NPI Number Information
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NPI Number | 1134076292
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Entity Type | Individual
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Provider Name | KRISTIAN VOULOPOS
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Gender |
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 5734 W 13400 S STE 100
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City | HERRIMAN
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State | UT
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Zip | 84096-6953
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Country | US
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Telephone | 180-154-2099
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Fax |
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Provider Business Mailing Address
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Address Line | 13836 S GLEN LAUREL CIR
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City | RIVERTON
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State | UT
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Zip | 84065-2362
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14228008-9926
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License Number State | UT
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