Healthcare Provider Details

I. General information

NPI: 1750953485
Provider Name (Legal Business Name): DANIEL EPPERSON DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1737 N 2000 W STE G
CLINTON UT
84015-8215
US

IV. Provider business mailing address

1667 COCHRANE CIR
FORT CARSON CO
80913-4603
US

V. Phone/Fax

Practice location:
  • Phone: 801-728-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number37241
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14285379-9923
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00206392
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: