Brady E Benson, DDS
Individual provider Active NPI Dentist · Brigham City, UT
NPI 1669464962 · NPPES record last updated Sep 8, 2008
Key facts
- NPI
- 1669464962
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6213980-9922 (UT)
- Practice address
- 111 E Forest St
Suite F
Brigham City, UT 84302-2127 - Phone
- (435) 723-2318
- Fax
- (435) 723-3684
- NPI assigned
- Aug 22, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-3756 | ID | MD | Dentist |
| 6213980-9922 | UT | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D-3756 | ID | |
| Dentist | 122300000X | 6213980-9922 | UT | Yes |
Addresses
Primary practice location
111 E Forest St
Suite F
Brigham City, UT 84302-2127
Mailing address
111 E Forest St
Suite F
Brigham City, UT 84302-2127
Phone (435) 723-2318
Other providers in Brigham City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.