Active NPI
Brent Jay Isakson, D.M.D.
- General Practice Dentistry
- Roy, UT
National Provider Identifier
1255535167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 138541-9922
- Practice address
- 5139 S 1900 W
Roy, UT 84067-2997 - Phone
- (801) 773-8212
- NPI assigned
- Jun 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 138541-9922 | UT | Primary |
Addresses
Primary practice location
5139 S 1900 W
Roy, UT 84067-2997
Mailing address
5139 S 1900 W
Roy, UT 84067-2997
Phone (801) 773-8212
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
| License | State | Type | Specialty |
|---|---|---|---|
| 138541-9922 | UT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255535167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5139 S 1900 W",
"city": "ROY",
"state": "UT",
"postal_code": "840672997",
"telephone_number": "801-773-8212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5139 S 1900 W",
"city": "ROY",
"state": "UT",
"postal_code": "840672997",
"telephone_number": "801-773-8212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISAKSON",
"first_name": "BRENT",
"middle_name": "JAY",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "138541-9922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.