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General NPI Number Information
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NPI Number | 1962355222
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Entity Type | Organization
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Legal Business Name | CARE SPECIAL NEEDS DENTAL LLC
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 151 E 5600 S STE 104
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-8140
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Country | US
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Telephone | 801-833-0515
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Fax |
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Provider Business Mailing Address
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Address Line | 151 E 5600 S STE 100
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-8139
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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 | MANAGING MEMBER
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Name | GARY BRANDON KEHL
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Credential |
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Telephone | 801-560-6408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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