Brenda Fuell, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

5328674-9920 Issued in UT

Practice address

12959 South Picket Fence Lane
Riverton, UT 84065

Phone

(801) 712-1154

NPI assigned

Sep 9, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023537156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12959 S PICKET FENCE LN",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840656933",
            "telephone_number": "801-712-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12959 SOUTH PICKET FENCE LANE",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "84065",
            "telephone_number": "801-712-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUELL",
        "first_name": "BRENDA",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "UT",
            "license": "5328674-9920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David Lee Furuta, PA-C
• David Futrell Jr., CPSS
• Amanda Leigh Gagnon
• Nicholas Gajkowski, MD

• Dental Hygienist in Riverton, UT
• Providers in Riverton, UT by specialty
• Dental Hygienist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.