Bradley J Deitch, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

13814366-9926 Issued in UT

Practice address

533 W 2600 S Ste 225
Bountiful, UT 84010-7762

Phone

(801) 292-7500

NPI assigned

Jul 26, 2023

Last updated

Jun 26, 2025By the provider in NPPES

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

Practice roles

Locations

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.

• Elevate Dental Partners

  • General Practice Dentistry
  • Bountiful, UT
  • NPI 1982472536
  NPD
• Packard Dental PC

  • General Practice Dentistry
  • Roy, UT
  • NPI 1831421155
  NPD (past)

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1801577580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 W 2600 S STE 225",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107762",
            "telephone_number": "801-292-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 W 2600 S STE 225",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107762",
            "telephone_number": "801-292-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITCH",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS044123",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "13814366-9926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody E De Jonge, R.N.
• Michelle Nicole Dean, DPT
• Cayla Decocq
• Diedra Decorso
• Troy Dennis Dedecker, DDS
• Jacob Delamare
• Kort H. Delost, RPH
• Denali Medical Center
• Denali Specialty Clinic LLC
• Gladys Dennis

• Dentist in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.