Healthcare Provider Details

I. General information

NPI: 1154002467
Provider Name (Legal Business Name): MATTHEW S. BRINKERHOFF, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 RENAISSANCE TOWNE DR STE 102
BOUNTIFUL UT
84010-7513
US

IV. Provider business mailing address

1512 RENAISSANCE TOWNE DR STE 102
BOUNTIFUL UT
84010-7513
US

V. Phone/Fax

Practice location:
  • Phone: 801-298-7728
  • Fax: 801-292-0910
Mailing address:
  • Phone: 801-298-7728
  • Fax: 801-292-0910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW S BRINKERHOFF
Title or Position: DENTIST OWNER
Credential: DMD
Phone: 801-298-7728