BRANDON NAKKEN (NPI# 1902285190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902285190 |
Entity Type | Individual |
Full Name | BRANDON NAKKEN |
Credential | DDS |
Practice Address |
65 N Gateway Dr Ste 1 Providence UT 84332-6102 |
Practice Telephone | 4357529296 |
Mailing Telephone | (435) 787-2223 |
Enumeration Date | 2015-05-21 |
Last Update Date | 2017-09-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
10335222-8903 | UT | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
UT | 1902285190 | 05 |
Street Address |
65 N GATEWAY DR STE 1 |
City | PROVIDENCE |
State | UT |
Zip Code | 84332-6102 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992119390 | Abc Pediatric Dentistry, PC | Dentist | 65 N Gateway Dr Ste 1, Providence, UT 84332-6102 | 2014-06-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881292167 | 3bc Incorporated | Pharmacy | 435 North Gateway Drive #802, Providence, UT 84332 | 2020-10-09 |
1962049932 | Wholelife Family Wellness Clinic of Providence Pllc | Counselor | 169 N Gateway Dr. Suite 170, Providence, UT 84332 | 2019-12-09 |
1033503420 | Spring Creek Surgical Center, LLC | Clinic/Center | 65 North Gateway Drive, Suite 3, Providence, UT 84332 | 2015-03-24 |
1558751438 | Naturopathic Medical, P.C. | Naturopath | 565 W. 465 N., Suite 150, Providence, UT 84332 | 2015-01-29 |
1821421710 | Erin Campbell | Physical Therapist | 267 West Spring Creek Parkway, Providence, UT 84332 | 2013-08-14 |
1285981530 | Jordan Joseph Hansen | Dentist | 169 N Gateway Drive, Suite 200, Providence, UT 84332 | 2012-08-06 |
1598086720 | Cory B Maughan | Dermatology | 169 N Gateway Dr Ste 100, Providence, UT 84332 | 2010-06-22 |
1528299245 | South Valley Eyecare Center, Inc. | Optometrist | 276 Springcreek Pkwy, Providence, UT 84332 | 2009-07-29 |
1316134356 | Heather Saxton Maughan | Speech-Language Pathologist | 344 E Edgehill Dr, Providence, UT 84332 | 2007-10-03 |
1902021538 | Brad L Thomas | Physical Therapist | 169 Spring Creek Park Way, Suite 140, Providnce, UT 84332 | 2007-04-17 |
Find all providers in zip 84332 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992119390 | Abc Pediatric Dentistry, PC | Dentist | 65 N Gateway Dr Ste 1, Providence, UT 84332-6102 | 2014-06-13 |
1457794315 | Kurt Gordon Vest | Dentist | 169 N Gateway Dr Ste 105, Providence, UT 84332-9861 | 2013-04-10 |
1275583874 | Farisa Surattanont Mulvey | Dentist | 148 Waterman St, Providence, RI 02906-2130 | 2006-05-12 |
1912963935 | Stanton Cannon Allen | Dentist | 65 N. Gateway Drive, Ste #1, Providence, UT 84332-6102 | 2006-04-26 |
1487216685 | Wasatch Pediatric Dentistry, PC | Dentist | 169 N Gateway Dr Ste 105, Providence, UT 84332-9861 | 2019-07-08 |
1194165167 | Amir Yavari | Dentist | 21 Peace St, Providence, RI 02907 | 2013-07-05 |
1942565486 | Jeffrey W Higbee | Dentist | 21 Peace St, Providence, RI 02907-1510 | 2012-07-11 |
1871858233 | Derek Nobrega | Dentist | 21 Peace St, Providence, RI 02907-1510 | 2012-07-11 |
1427215656 | Douglas D Warner | Dentist | 21 Peace St, Providence, RI 02907-1510 | 2008-05-16 |
1942322458 | Thomas S. Mulvey Dds LLC | Dentist | 111 Point Street, Suite 1, Providence, RI 02903 | 2007-04-04 |
Find all providers in PROVIDENCE |
City | PROVIDENCE |
Zip Code | 84332 |
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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.