Dr. Kim E Samuelson , DMD
Dentist - General Practice • Centerville, UT
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kim Samuelson has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Kim Samuelson, DMD was a registered Dentist - General Practice practicing in Centerville, UT. Throughout an active medical career spanning 17 years, Dr. Samuelson provided care at the practice location at 80 S MAIN ST until profile deactivation on 2024-07-31.
Practice Location & Contact Primary Location
80 S Main St
Centerville, UT 840141817
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Centerville, UT
Practicing in Centerville, UT (1388 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
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.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Dental Hygienist
Registered Dental Hygienist
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on July 31, 2024
NPI status registered as active in NPPES database
Registered at 80 S MAIN ST, CENTERVILLE, UT 840141817 (Tel: 8012926995)
Registered at PO BOX 1288, CENTERVILLE, UT 840145288 (Tel: 8012926995)
Recorded as KIM SAMUELSON, D.M.D.
Dentist (License #138007 in UT)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
Po Box 1288
Centerville, UT 840145288
Phone: 8012926995
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