Layne C Brown, DDS

Individual provider Active NPI General Practice Dentistry · Holladay, UT

NPI 1851440283 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1851440283
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
293913-9922 (UT)
Practice address
1345 E 3900 S
Suite 206
Holladay, UT 84124-1474
Phone
(801) 278-1333
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
293913-9922UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
39TH & 13TH Street Dental Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 293913-9922 UT Yes

Addresses

Primary practice location

1345 E 3900 S
Suite 206
Holladay, UT 84124-1474

Mailing address

1345 E 3900 S
206
Holladay, UT 84124-1474
Phone (801) 278-1333

Other providers in Holladay, UT

All providers in Holladay, UT · General Practice Dentistry in Utah

Sources for this page

Verify at the official NPI Registry.