Brady Benjamin Nielsen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10383844-9922 Issued in UT

Practice address

880 Heritage Park Blvd Ste 220
Layton, UT 84041-5680

Phone

(801) 728-4688

NPI assigned

Jun 9, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Woodland Park Dental P.C.

  • General Practice Dentistry
  • Layton, UT
  • NPI 1477696235
  NPD (past)

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496966400000",
    "number": "1437688694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3759 W 850 S",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840759807",
            "telephone_number": "801-686-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 HERITAGE PARK BLVD STE 220",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415680",
            "telephone_number": "801-728-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "BRADY",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-09",
        "last_updated": "2017-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "10383844-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loan Thihong Nguyen, RPH
• Camille Nichols
• Steven Brandon Nickle, D.O
• Nate Nicoll
• Jenna Niederhauser
• Brandon Nielsen
• Bryan Lowell Nielsen
• Jeffery C Nielsen, RPH
• Macie Nielsen
• Michael S Nielsen, M.D.

• General Practice Dentistry in Layton, UT
• Providers in Layton, 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 Jun 9, 2017; 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.