Individual provider Active NPI

Bruce G Howard, DDS

  • Dentist
  • Kaysville, UT
National Provider Identifier
1720193881
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1379599922 Issued in UT
Practice address
475 N 300 W
Suite 1
Kaysville, UT 84037-3125
Phone
(801) 546-2413
Fax
(801) 546-1900
NPI assigned
Aug 20, 2006
Last updated
Sep 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1379599922 UT Primary

Addresses

Primary practice location

475 N 300 W
Suite 1
Kaysville, UT 84037-3125

Mailing address

475 N 300 W
Ste 1
Kaysville, UT 84037-3112
Phone (801) 546-2413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160915000430 UT Order and Referring Only - Other (Non-Physician) 2769778869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1379599922UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Godfrey Family Dental LLC PastSince Jun 22, 2021 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1720193881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 N 300 W",
            "address_2": "STE 1",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840373112",
            "telephone_number": "801-546-2413",
            "fax_number": "801-546-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 N 300 W",
            "address_2": "SUITE 1",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840373125",
            "telephone_number": "801-546-2413",
            "fax_number": "801-546-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "BRUCE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "1379599922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaysville, UT

Sources for this page

Verify at the official NPI Registry.