NPIMap

Individual provider Active NPI

Bryan Glen Trump, DDS, MS

  • Oral and Maxillofacial Pathology Dentistry
  • Salt Lake City, UT
National Provider Identifier
1083973002
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
9021109-9921 Issued in UT
Practice address
530 S Wakara Way
Salt Lake City, UT 84108-1213
Phone
(801) 587-6189
Fax
(801) 585-6485
NPI assigned
May 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 9021109-9921 UT Primary

Addresses

Primary practice location

530 S Wakara Way
Salt Lake City, UT 84108-1213

Mailing address

530 S Wakara Way
Salt Lake City, UT 84108-1213
Phone (801) 587-6189

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address btrump160750@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150702001888 UT Practitioner - Pathology 5294047346 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Virginia Commonwealth Univ School of Dentistry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Dental ServicesGroup PAC ID 0244542595, 4 clinicians
Dermatology Division University of Utah Medical CenterGroup PAC ID 9638073497, 73 clinicians
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 213-3900

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-3229

530 S Wakara Way
Salt Lake City, UT 84108-1213
Phone (801) 587-6453

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Merit-based Incentive Payment System (MIPS)

Final score
81.84 of 100Reported as group
Quality
87.03
Promoting interoperability
100
Improvement activities
40
Cost
52.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Dental Services CurrentSince Dec 23, 2017 Accepting new patients
University of Utah Dental Services Current Accepting new patients
University of Utah CurrentSince May 23, 2015 Accepting new patients
University of Utah Adult Services CurrentSince May 23, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah CurrentSince May 23, 2015 Accepting new patients
University of Utah Dental Services CurrentSince Dec 23, 2017 Accepting new patients
Dermatology Division University of Utah Medical Center CurrentSince Nov 28, 2020 Accepting new patients
University of Utah Adult Services CurrentSince May 23, 2015 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
U-U Pediatric Dermatology PastSince May 24, 2020 Accepting new patients
University of Utah Dental Services Past Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

530 S Wakara Way
Slc, UT 84108
Phone (801) 581-8951

Interoperability endpoints

  • Direct secure messaging: btrump160750@direct.med.utah.edu

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1083973002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081213",
            "telephone_number": "801-587-6189",
            "fax_number": "801-585-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081213",
            "telephone_number": "801-587-6189",
            "fax_number": "801-585-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUMP",
        "first_name": "BRYAN",
        "middle_name": "GLEN",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-11",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "UT",
            "license": "9021109-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "btrump160750@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.