MICAH WEISENBERG (NPI# 1588049233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588049233 |
| Entity Type | Individual |
| Full Name | MICAH WEISENBERG |
| Credential | DDS |
| Practice Address |
1144 E Fort Union Blvd Midvale UT 84047 |
| Mailing Address |
1235 E Wilmington Ave Apt 317 Salt Lake City UT 84106-4265 |
| Practice Telephone | 8015663118 |
| Mailing Telephone | 3016611459 |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2018-05-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 10757585-9922 | UT | Dental Providers |
| N | 122300000X | Dentist | 15995 | MD | Dental Providers |
| Street Address |
1144 E FORT UNION BLVD |
| City | MIDVALE |
| State | UT |
| Zip Code | 84047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366566960 | Donovan Sonny Browning | Dentist | 1144 E Fort Union Blvd, Midvale, UT 84047-1804 | 2007-03-19 |
| 1700163003 | Stuart Covington Fry | Dentist | 1144 E Fort Union Blvd, Midvale, UT 84047-1804 | 2011-11-15 |
| 1396030003 | Jeri Lynn Bullock | Dentist | 1144 E Fort Union Blvd, Midvale, UT 84047-1804 | 2011-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885096 | Wound Pros Utah | Durable Medical Equipment & Medical Supplies | 6975 Union Park Avenue, Suite 600, Cottonwood Heights, UT 84047 | 2020-09-12 |
| 1457965824 | Duy Danny Vo | Pharmacist | 7200 S State St, Midvale, UT 84047 | 2020-09-03 |
| 1619457314 | Tlcpo LLC | Counselor | 6975 Union Park Avenue Suite 600, Cottonwood Heights, UT 84047 | 2018-08-21 |
| 1700371606 | Heather Ivana Lawrence | Social Worker | 6856 700 E, Midvale, Ut 84047, Midvale,ut, UT 84047 | 2018-06-25 |
| 1285128942 | A&a Counseling | Counselor | 7602 S Main St, Midvale, UT 84047 | 2018-06-17 |
| 1396235339 | Hhalmid | Assisted Living Facility | 6968 S 700 E, Midvale, UT 84047 | 2018-05-15 |
| 1750879987 | Rosemarie Elaine Brinig | Counselor | 75 E. Ft. Union, C118, Midvale, UT 84047 | 2018-04-24 |
| 1861921140 | Olivia Devenport | Behavior Technician | 7434 S State Street, Midvale, UT 84047 | 2017-06-08 |
| 1376083071 | Marathon Health, LLC | Nurse Practitioner | 7259 South Bingham Junction, C/o Chg- Ut Health Center, Midvale, UT 84047 | 2017-02-28 |
| 1710436316 | Michael Naanes | Physical Therapist | 900 East 6900 South, Suite 100, Midvale, UT 84047 | 2016-09-25 |
| Find all providers in zip 84047 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891048823 | Daniel Johnson Poelman | Dentist | 714 E Fort Union Blvd, Midvale, UT 84047-2347 | 2012-10-15 |
| 1386779601 | Thomas R Dickson | Dentist | 714 Fort Union Blvd, Midvale, UT 84047-2347 | 2007-02-23 |
| 1174690432 | Grant O Quayle | Dentist | 1275 E Fort Union Blvd, Suite 200, Midvale, UT 84047 | 2006-11-29 |
| 1528139003 | Ryan Scott Mcneil | Dentist | 6895 S 900 E, Suite B, Midvale, UT 84047-1758 | 2006-11-13 |
| 1083703649 | Raymond J Curtis | Dentist | 7001 South 900 E, Suite 350, Midvale, UT 84047 | 2006-10-12 |
| 1346341641 | Kenneth John Marz | Dentist | 918 Fort Union Blvd, Midvale, UT 84047-1714 | 2006-09-26 |
| 1417978909 | Lynn Walker | Dentist | 7679 Center Sq, Midvale, UT 84047-7329 | 2006-07-21 |
| 1598783615 | Gerald Ray Berg | Dentist | 7001 S 900 E, Ste #450, Midvale, UT 84047-1718 | 2006-07-17 |
| 1326305517 | Lester William Cannon | Dentist | 714 Fort Union Blvd, Midvale, UT 84047-2347 | 2012-04-12 |
| 1700163003 | Stuart Covington Fry | Dentist | 1144 E Fort Union Blvd, Midvale, UT 84047-1804 | 2011-11-15 |
| Find all providers in MIDVALE | ||||
Please comment or provide details below to improve the information on MICAH WEISENBERG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.