Forever Young Dentistry Pllc is a renowned Dental office in Provo, Utah. This organization is also known as sub part of Forever Young Dentistry. It is located at 2335 S. State Street, Ste #200, Provo, UT and its contact number is 801-225-1630. The authorized person for Forever Young Dentistry Pllc is Ms. Reyna M Madriles
who is Co-owner of the place and their contact number is 801-225-1630.
Forever Young Dentistry Pllc Office is a healthcare facility where dedicated dental team composed of licensed professionals, including dentists (DDS or DMD), dental hygienists, dental assistants, and administrative staff (manage appointments, billing, and patient records) provides preventive, diagnostic, and therapeutic oral health services like oral exams and X-rays, fillings, fluoride treatments, teeth cleanings, implants, crowns, bridges, tooth extractions, root canals, and cosmetic procedures such as teeth whitening, braces and veneers to patients through outpatient care.
Complete Profile:
Forever Young Dentistry Pllc Office speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Forever Young Dentistry Pllc |
| Specialization: | Dentistry |
| Address: | 2335 S. State Street, Ste #200, Provo,
Utah, 84606 |
| Phone: | 801-225-1630 |
| Fax: | 801-225-1630 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this Office are as below. Person's position and contact details are also mentioned below.
| Name: | Ms. Reyna M Madriles |
| Position: | Co-owner |
| Contact Number: | 801-225-1630 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Forever Young Dentistry Pllc Office are as mentioned below.
| NPI Number: | 1508236795 |
| Parent Organization: | Forever Young Dentistry |
| NPI Enumeration Date: | 30 Sep, 2015 |
| NPI Last Update On: | 30 Sep, 2015 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Forever Young Dentistry Pllc are as mentioned below.
| Specialization | License Number | State | Status | |
| Dental | | Utah | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the Office such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 564618729-001 | Medicaid | Utah | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Forever Young Dentistry Pllc
2335 S. State Street, Ste #200
Provo, Utah |
| Zip: | 84606 |
| Phone Number: | 801-225-1630 |
| Fax Number: | 801-404-5802 |
Patients can reach Forever Young Dentistry Pllc at
2335 S. State Street, Ste #200, Provo, Utah or can
call to book an appointment on 801-225-1630.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
09 March, 2026.