Boyd Bandy, D.M.D
Individual provider Active NPI Dentist · Beaver, UT
NPI 1003266057 · NPPES record last updated Jun 20, 2016
Key facts
- NPI
- 1003266057
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 9829784-9922 (UT)
- Practice address
- 55 N 400 E
Beaver, UT 84713-7710 - Phone
- (307) 630-9755
- NPI assigned
- Jun 20, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9829784-9922 | UT | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9829784-9922 | UT | Yes |
Addresses
Primary practice location
55 N 400 E
Beaver, UT 84713-7710
Mailing address
1298 N Willowbrook
Saratoga Springs, UT 84045-3201
Phone (307) 630-9755
Other providers in Beaver, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.