Dr. Kelly A Faddis
Dentist - General Practice
11760 S 700 E #110
Draper
, Utah 84020-6604
Dr. Kelly A Faddis
Dentist - General Practice
11760 S 700 E #110
Draper
, Utah 84020-6604
(801) 571-7787
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About
Features
Specialties
- General Practice
Languages spoken
- English
Location
First Address
- Dr. Kelly A Faddis
- 11760 S 700 E #110
- Draper, UT
- Zip : 84020-6604
- Fax : (801) 571-7787
- Phone : (801) 571-6688
Second Address
- Dr. Kelly A Faddis
- 11760 S 700 E #110
- Draper, UT
- Zip : 84020-6604
- Fax : (801) 571-7787
- Phone : (801) 571-6688
Reviews
FAQs
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Is Dr. Kelly A Faddis a sole practitioner?
Is Dr. Kelly A Faddis accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223G0001X | General Practice | 144920-9922 | UT |
| Y | 213EG0000X | General Practice | 144920-9922 | UT |
National Provider Identifier
| NPI | 1003858432 |
|---|---|
| Provider Name | Dr. Kelly A Faddis |
| First Address | Draper, UT 84020-6604 |
| Second Address | Draper, UT 84020-6604 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/06/2006 |
| Last Update Date | 31/05/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 87-0581297 | FEDERAL ID # (01) | 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.