104 West Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

104 WEST DENTAL LLC

Practice address

104 W 200 S
Brigham City, UT 84302-2506

Phone

(435) 734-2394

Fax

(435) 734-0117

NPI assigned

Dec 3, 2025

Last updated

Dec 3, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel Nelson, DDSNPI 1346257169

Title

Member

Phone

(435) 734-2394

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Keith Nelson, D.D.S.

  • General Practice Dentistry
  • Brigham City, UT
  • NPI 1346257169
  NPD Authorized official
• Howard Rainey Daines, D.D.S.

  • General Practice Dentistry
  • Brigham City, UT
  • NPI 1093810954
  NPD (past)

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1255294765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 200 S",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843022506",
            "telephone_number": "435-734-2394",
            "fax_number": "435-734-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 200 S",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843022506",
            "telephone_number": "435-734-2394",
            "fax_number": "435-734-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "104 WEST DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-03",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "435-734-2394",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Home Health Care (At Home Health Care)
• Reuben Abbott
• Cody Bruce Abrams
• Access Healthcare, LLC
• Justin Darrell Ackerman

• General Practice Dentistry in Brigham City, UT
• Providers in Brigham City, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.