Healthcare Provider Details

I. General information

NPI: 1922934314
Provider Name (Legal Business Name): BRADY CARLEN DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N 1000 W STE 140
LOGAN UT
84321-3759
US

IV. Provider business mailing address

1827 N 340 W
LOGAN UT
84341-7102
US

V. Phone/Fax

Practice location:
  • Phone: 435-753-4227
  • Fax: 435-213-2480
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: BRADY CARLEN
Title or Position: OWNER/GENERAL DENTIST
Credential: DDS
Phone: 435-512-6288