Dennis Dedecker
Oral and Maxillofacial Surgeon
2185 N 1700 W #204
Layton
, Utah 84041-1154
Dennis Dedecker
Oral and Maxillofacial Surgeon
2185 N 1700 W #204
Layton
, Utah 84041-1154
(801) 544-2863
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dennis Dedecker
- 447 E 700 N Twin Creek Circle
- Kaysville, UT
- Zip : 84037
- Phone : (801) 544-2863
Second Address
- Dennis Dedecker
- 2185 N 1700 W #204
- Layton, UT
- Zip : 84041-1154
- Fax : (801) 773-9792
- Phone : (801) 773-9790
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 1356659924 | UT |
National Provider Identifier
| NPI | 1073516688 |
|---|---|
| Provider Name | Dennis Dedecker |
| First Address | Kaysville, UT 84037 |
| Second Address | Layton, UT 84041-1154 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/05/2005 |
| Last Update Date | 05/04/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000058020 | MEDICARE GROUP (01) | UT |
| 107004925101 | SELECTHEALTH # (01) | UT |
| 190000851 | RAILROAD MEDICARE # (01) | UT |
| 190644 | UNITED CONCORDIA # (01) | UT |
| 35697 | DMBA PROVIDER # (01) | UT |
| 43-00008 | UNITEDHEALTH CARE (UHC) # (01) | UT |
| 64163 | PUBLIC EMPLOYEES (PEHP) # (01) | UT |
| 870344080DE1 | EDUCATORS MUTUAL # (01) | UT |
| T08526 | (02) | UT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.