Provider Demographics
NPI:1902598683
Name:SCHOUTEN, DANIEL RYAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RYAN
Last Name:SCHOUTEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12090 S 3600 W
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-7607
Mailing Address - Country:US
Mailing Address - Phone:801-824-7344
Mailing Address - Fax:
Practice Address - Street 1:133 S 500 E
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-9903
Practice Address - Country:US
Practice Address - Phone:435-247-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13405471-99221223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health