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CANYON ROAD DENTAL PLLC
NPI 1700450905
Dentist - General Practice in Provo, UT

Active since May 13, 2021
3707 N CANYON RD STE 2A, PROVO, UT 84604(801) 997-6728(385) 374-1555 Get Directions Write a Review

NPPES record last updated: May 13, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Canyon Road Dental Pllc NPPES

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

CANYON ROAD DENTAL PLLC (NPI 1700450905), doing business as Canyon Road Dental, is a healthcare organization registered as a general practice in Provo, Utah and active in the NPI registry since May 2021. The organization lists Faith Gaskins, Director Of Credentialing, as its authorized official.

NPPES Registry Identity

NPI1700450905
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCANYON ROAD DENTAL PLLC
Location Address3707 N CANYON RD STE 2AProvo, UT 84604-4525
Mailing Address3707 N Canyon Rd Ste 2aProvo, UT 84604-4525 · (801) 997-6728 · Fax (385) 374-1555
Phone(801) 997-6728
Fax(385) 374-1555
Organization SubpartNo
Authorized OfficialFaith GaskinsDirector Of Credentialing · (972) 869-3789
Enumeration DateMay 13, 2021
NPPES CertifiedMay 13, 2021
✔ NPI 1700450905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
3707 N CANYON RD STE 2A, Provo, UT 84604
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Other Names 1

Doing Business AsCanyon Road Dental

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

DR. HAHNGOO JUSTIN KAHNG DDS
Dentist
3707 N CANYON RD STE 2A
PROVO, UT 84604
Utah County (801) 997-5875
RENAISSANCE DENTAL & SURGICAL ARTS, INC.
Dentist (Periodontics)
3707 N CANYON RD STE 2A
PROVO, UT 84604
Utah County (951) 294-7230

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 Canyon Road Dental PLLC's NPI number?

The NPI number for Canyon Road Dental PLLC is 1700450905. It was assigned to this organization in the NPPES registry on May 13, 2021. The provider is doing business as Canyon Road Dental.

Where is Canyon Road Dental PLLC located?

Canyon Road Dental PLLC is located at 3707 N Canyon Rd Ste 2A, Provo, UT 84604. The listed phone number is (801) 997-6728.

What is Canyon Road Dental PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Canyon Road Dental PLLC was last updated on May 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.