Jesse K Bloomfield, DMD
Individual provider Active NPI General Practice Dentistry · Delta, UT
NPI 1043661945 · NPPES record last updated Nov 18, 2020
Key facts
- NPI
- 1043661945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DEN.00202874 (CO)
- Practice address
- 60 S 300 E
Delta, UT 84624-5551 - Phone
- (435) 864-5195
- Fax
- (435) 864-5199
- NPI assigned
- Jun 22, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00202874 | CO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Mountain Dental LLC | Current |
Accepting new patients | |
| Lafayette Dental Partners, Prof. LLP | General Practice | Past | Accepting new patients |
| Merit Dental Group | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN.00202874 | CO | Yes |
Addresses
Primary practice location
60 S 300 E
Delta, UT 84624-5551
Mailing address
PO Box 310
Delta, UT 84624-0310
Phone (435) 864-5195
Other providers in Delta, UT
- Auralcare Hearing Centers of America, LLC
- Jamie Mae Backer
- Jacob Donald Bailey
- Jared Bailey
- Darin Wesley Bloomfield
- Blue Mountain Dental LLC
- Canyon View Medical Group LLC
- Shaylee Claire Carcamo
- Sonja L. Cazier
- Thomas Earl Chandler
All providers in Delta, UT · General Practice Dentistry in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2020. 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.