Michael G Boyack, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5114556 Issued in UT

Practice address

3451 S 5600 W
West Valley City, UT 84120-1301

Phone

(801) 969-1400

Fax

(801) 969-1401

NPI assigned

Nov 11, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1649424029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 S. STATE STREET",
            "city": "OREM",
            "state": "UT",
            "postal_code": "84097",
            "telephone_number": "801-224-0222",
            "fax_number": "801-226-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 S 5600 W",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841201301",
            "telephone_number": "801-969-1400",
            "fax_number": "801-969-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYACK",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-11",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "5114556",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5114556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Borshanian, NP
• Talmage Lee Bourne, MD
• Charles Mikell Bova, M.D.
• Corinne Bowen
• Todd Alan Bowman Sr., D.M.D.
• Kelsey Bradley
• Staci Janae Brandenburg, PA-C
• Craig A Brasher, MD
• Kinzey Brice
• Robert Reginald Bridges, RPH

• General Practice Dentistry in West Valley City, UT
• Providers in West Valley 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 Jul 17, 2013; 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.