Active NPI
McKinsee Broderick Weyher, DDS
- Dentist
- Salt Lake City, UT
National Provider Identifier
1306152889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8088273-9922
- Practice address
- 2114 S Highland Dr
Salt Lake City, UT 84106-2807 - Phone
- (385) 399-0537
- Fax
- (801) 880-8835
- NPI assigned
- Aug 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 59546 | CA | |
| Dentist | 122300000X | 1361 | AK | |
| Dentist | 122300000X | 8088273-9922 | UT | Primary |
Addresses
Primary practice location
2114 S Highland Dr
Salt Lake City, UT 84106-2807
Mailing address
2114 S Highland Dr
Salt Lake City, UT 84106-2807
Phone (385) 399-0537
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1361 | Other | AK | DENTAL LICENSE |
| 59546 | Other | CA | DENTAL LICENSE |
| 8088273-9922 | Other | UT | UTAH DENTAL LICENSE |
Other names 1
- McKinsee Cathryn Broderick
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59546 | CA | MD | Dentist |
| 8088273-9922 | UT | MD | Dentist |
| 1361 | AK | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483142400000",
"number": "1306152889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2114 S HIGHLAND DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841062807",
"telephone_number": "385-399-0537",
"fax_number": "801-880-8835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2114 S HIGHLAND DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841062807",
"telephone_number": "385-399-0537",
"fax_number": "801-880-8835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEYHER",
"first_name": "MCKINSEE",
"middle_name": "BRODERICK",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-23",
"last_updated": "2016-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "59546",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "1361",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "8088273-9922",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "1361",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "59546",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UTAH DENTAL LICENSE",
"identifier": "8088273-9922",
"state": "UT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MCKINSEE",
"last_name": "BRODERICK",
"middle_name": "CATHRYN",
"credential": "DDS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.