Active NPI
Bryan Vern Sonntag, MD
- Plastic Surgery Physician
- South Jordan, UT
National Provider Identifier
1558418673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- UT-317539-1205
- Practice address
- 10437 S Jordan Gtwy
South Jordan, UT 84095-3915 - Phone
- (801) 571-7710
- Fax
- (801) 571-7738
- NPI assigned
- Jan 3, 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 |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | UT-317539-1205 | UT | Primary |
Addresses
Primary practice location
10437 S Jordan Gtwy
South Jordan, UT 84095-3915
Mailing address
10437 S Jordan Gtwy
South Jordan, UT 84095-3915
Phone (801) 571-7710
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UT-317539-1205 | UT | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558418673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10437 S JORDAN GTWY",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840953915",
"telephone_number": "801-571-7710",
"fax_number": "801-571-7738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10437 S JORDAN GTWY",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840953915",
"telephone_number": "801-571-7710",
"fax_number": "801-571-7738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONNTAG",
"first_name": "BRYAN",
"middle_name": "VERN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "UT",
"license": "UT-317539-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Jordan, 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.