1396627089 NPI number — VALLEY IMPLANTS ORAL SURGERY AND ENDODONTICS PLLC

Table of content: DR. JAY C. HUDSON DDS (NPI 1396858643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396627089 NPI number — VALLEY IMPLANTS ORAL SURGERY AND ENDODONTICS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY IMPLANTS ORAL SURGERY AND ENDODONTICS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396627089
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1146 W 2700 N
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
PLEASANT VIEW
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84414
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-298-2242
Provider Business Mailing Address Fax Number:
801-294-9920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1146 W 2700 N
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
PLEASANT VIEW
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-298-2242
Provider Business Practice Location Address Fax Number:
801-294-9920
Provider Enumeration Date:
07/23/2025

Additional Information

Authorized Official

Authorized Official Last Name:
SORENSEN
Authorized Official First Name:
TRAVIS
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
801-298-2242

Provider Taxonomy Codes

  • Taxonomy code: 1223E0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223S0112X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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