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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

VITA LUXE, LLC
NPI 1093628786
Otolaryngology - Facial Plastic Surgery in Salt Lake City, UT

Active since September 24, 2026
6322 S 3000 E STE 170, SALT LAKE CITY, UT 84121(801) 513-3223 Get Directions Write a Review

NPPES record added: September 24, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Vita Luxe, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VITA LUXE, LLC (NPI 1093628786) is a healthcare organization registered as a facial plastic surgery in Salt Lake City, Utah and active in the NPI registry since September 2026. The organization lists Jeremy Poulsen, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1093628786
Entity TypeOrganization
Primary Taxonomy207YS0123X
Legal Business NameVITA LUXE, LLC
Location Address6322 S 3000 E STE 170Salt Lake City, UT 84121-7290
Mailing Address6322 S 3000 E Ste 170Salt Lake City, UT 84121-7290 · (801) 513-3223
Phone(801) 513-3223
Organization SubpartNo
Authorized OfficialJeremy PoulsenManaging Member · (559) 313-6472
Enumeration DateSeptember 24, 2026
NPPES CertifiedSeptember 24, 2026
✔ NPI 1093628786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YS0123X
Definition
An otolaryngologist who specializes in facial plastic surgery.
6322 S 3000 E STE 170, Salt Lake City, UT 84121
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BETHANY R POWERS M.D.
Otolaryngology (Plastic Surgery within the Head & Neck)
6322 S 3000 E STE 170
SALT LAKE CITY, UT 84121
Salt Lake County (801) 513-3223
FOREVER YOUNG MEDICAL SERVICES PC
Nurse Anesthetist, Certified Registered
6322 S 3000 E STE 170
SALT LAKE CITY, UT 84121
Salt Lake County (801) 513-3223
FORM SURGERY CENTER LLC
Clinic/Center (Ambulatory Surgical)
6322 S 3000 E STE 170
SALT LAKE CITY, UT 84121
Salt Lake County (801) 513-3223
DR. PRESTON DANIEL WARD MD
Otolaryngology (Facial Plastic Surgery)
6322 S 3000 E STE 170
SALT LAKE CITY, UT 84121
Salt Lake County (801) 739-3395

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vita Luxe, LLC's NPI number?

The NPI number for Vita Luxe, LLC is 1093628786. It was assigned to this organization in the NPPES registry on September 24, 2026.

Where is Vita Luxe, LLC located?

Vita Luxe, LLC is located at 6322 S 3000 E Ste 170, Salt Lake City, UT 84121. The listed phone number is (801) 513-3223.

What is Vita Luxe, LLC's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Facial Plastic Surgery, with taxonomy code 207YS0123X.

When was this NPI record last updated?

The NPPES record for Vita Luxe, LLC was last updated on September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.