Healthcare Provider Details

I. General information

NPI: 1184601940
Provider Name (Legal Business Name): DAVID G DIENHART MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 S. FASHION BLVD. SUITE 280
MURRAY UT
84107
US

IV. Provider business mailing address

2965 W 3500 S STE 280
WEST VALLEY CITY UT
84119-3602
US

V. Phone/Fax

Practice location:
  • Phone: 801-260-5864
  • Fax: 801-260-5865
Mailing address:
  • Phone: 801-965-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number277542-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number277542-1205
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number277542-1205
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number277542-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: