NPI 1093093312 · live from the CMS NPI Registry
Braden Cordell Atkins, D.M.D.
Dentist, Periodontics in West Valley City, UT. National Provider Identifier 1093093312, active.
NPI record
| NPI | 1093093312 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Periodontics 1223P0300X |
| Practice location | 4645 S 4000 W Ste B, West Valley City, UT 84120 |
| Practice phone | 216-264-6804 |
| Mailing address | 617 W 1825 N, Centerville, UT 84014 |
| Enumerated | August 3, 2011 |
| Last updated | April 5, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Periodontics primary | 1223P0300X | 9017911-9924 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.