Individual provider Active NPI

Bryant Paul Mackley, DDS

  • General Practice Dentistry
  • North Ogden, UT
National Provider Identifier
1205729852
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14225712 Issued in UT
Practice address
2201 N Washington Blvd
North Ogden, UT 84414-7210
Phone
(801) 782-6681
NPI assigned
Jun 2, 2025
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14225712 UT Primary

Addresses

Primary practice location

2201 N Washington Blvd
North Ogden, UT 84414-7210

Mailing address

1736 N 775 E
North Ogden, UT 84414-2966
Phone (801) 458-8436

Other practice location 1

4040 Midland Dr Ste 1
Roy, UT 84067-9606
Phone (801) 317-4407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14225712UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Midland Dental General Practice Past Accepting new patients
Northview Dental Associates LLC General Practice PastSince Jun 8, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1205729852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 N 775 E",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844142966",
            "telephone_number": "801-458-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 N WASHINGTON BLVD",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "844147210",
            "telephone_number": "801-782-6681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4040 Midland Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Roy",
            "state": "UT",
            "postal_code": "840679606",
            "country_code": "US",
            "telephone_number": "801-317-4407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKLEY",
        "first_name": "BRYANT",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "14225712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.