Basic Information
Provider Information
NPI: 1942823448
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNSHEE
FirstName: CHERISH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2621 S 3270 W
Address2:  
City: WEST VALLEY CITY
State: UT
PostalCode: 841191119
CountryCode: US
TelephoneNumber: 8019646214
FaxNumber:  
Practice Location
Address1: 4745 S 3200 W
Address2:  
City: TAYLORSVILLE
State: UT
PostalCode: 841292822
CountryCode: US
TelephoneNumber: 8019646214
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2020
LastUpdateDate: 05/19/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/19/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223D0001X11753454UTN Dental ProvidersDentistDental Public Health
1223G0001X11753454-9923UTY Dental ProvidersDentistGeneral Practice

No ID Information.


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