Healthcare Provider Details

I. General information

NPI: 1750205118
Provider Name (Legal Business Name): TANDEM HEALTH & AESTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5067 W SEBRING DR UNIT 104
HERRIMAN UT
84096
US

IV. Provider business mailing address

5053 W SEBRING DR 104
HERRIMAN UT
84096
US

V. Phone/Fax

Practice location:
  • Phone: 385-234-8696
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: USHA GAUTAM
Title or Position: APRN
Credential: APRN
Phone: 385-234-8696