Individual provider Active NPI

Brian D Duncan

  • Dentist
  • Taylorsville, UT
National Provider Identifier
1093817322
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
339130-9922 Issued in UT
Practice address
6183 Prairie View Dr Ste 104
Taylorsville, UT 84118-3203
Phone
(801) 969-0881
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 339130-9922 UT Primary

Addresses

Primary practice location

6183 Prairie View Dr Ste 104
Taylorsville, UT 84118-3203

Mailing address

6183 S. Prairie View Dr. #104
Taylorsville, UT 84118
Phone (801) 969-0881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20160414002046 UT Order and Referring Only - DentistPractitioner - Dentist 7517265101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093817322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6183 S. PRAIRIE VIEW DR. #104",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "84118",
            "telephone_number": "801-969-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6183 PRAIRIE VIEW DR STE 104",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841183203",
            "telephone_number": "801-969-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "BRIAN",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "339130-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, UT

Sources for this page

Verify at the official NPI Registry.