Braden Cordell Atkins, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

9017911-9924 Issued in UT

Practice address

4645 S 4000 W Ste B
West Valley City, UT 84120-6250

Phone

(216) 264-6804

NPI assigned

Aug 3, 2011

Last updated

Apr 5, 2021By the provider in NPPES

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Modern Dental Professionals - Utah, PC

  dba Monarch Dental - West Valley

  • Dentist
  • West Valley, UT
  • NPI 1720485709
  NPD
• Modern Dental Professionals - Utah, PC

  dba Monarch Dental - South Temple

  • Dentist
  • Salt Lake City, UT
  • NPI 1144022914
  NPD (past)
• Modern Dental Professionals Utah, PC

  dba Monarch Dental - Sandy

  • General Practice Dentistry
  • Sandy, UT
  • NPI 1487913869
  NPD (past)

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1093093312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 W 1825 N",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840143148",
            "telephone_number": "801-201-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 S 4000 W STE B",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841206250",
            "telephone_number": "216-264-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINS",
        "first_name": "BRADEN",
        "middle_name": "CORDELL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-03",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "UT",
            "license": "9017911-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tony Aspiazu
• Gina Marie Attallah, L.C.S.W.
• Lynne G. Atwood, CNM, CFNP
• Auralcare Hearing Centers of America, LLC (My Hearing Centers)
• Maile D Auvaa
• Norma Montserrat Avila

• Periodontics in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Periodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.