Provider Demographics
NPI:1891227898
Name:GORING, DARREN (DDS)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:
Last Name:GORING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 S 700 E STE 3
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2578
Mailing Address - Country:US
Mailing Address - Phone:801-261-8056
Mailing Address - Fax:801-261-8060
Practice Address - Street 1:4020 S 700 E STE 3
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2578
Practice Address - Country:US
Practice Address - Phone:801-261-8056
Practice Address - Fax:801-261-8060
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS5-481223P0700X
CA1001861223P0700X
UT10306848-99221223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty