Active NPI
Cory J Fabrizio, DMD
- Dentist
- West Jordan, UT
National Provider Identifier
1811215395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10158
- Practice address
- 9233 S Redwood Rd
West Jordan, UT 84088-5808 - Phone
- (801) 566-0971
- NPI assigned
- May 9, 2010
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 10158 | CO | Primary |
Addresses
Primary practice location
9233 S Redwood Rd
West Jordan, UT 84088-5808
Mailing address
2741 E Canton LN
Sandy, UT 84092-7126
Phone (801) 566-0971
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10158 | CO | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695859200000",
"number": "1811215395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2741 E CANTON LN",
"city": "SANDY",
"state": "UT",
"postal_code": "840927126",
"telephone_number": "801-566-0971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9233 S REDWOOD RD",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840885808",
"telephone_number": "801-566-0971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABRIZIO",
"first_name": "CORY",
"middle_name": "J",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-09",
"last_updated": "2023-09-28",
"certification_date": "2023-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "10158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.