Healthcare Provider Details

I. General information

NPI: 1467865816
Provider Name (Legal Business Name): DR. DANIEL ROBERTS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 03/03/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5349 ADAMS AVE PKWY STE C
OGDEN UT
84405-4736
US

IV. Provider business mailing address

5349 ADAMS AVE PKWY STE C
OGDEN UT
84405-4736
US

V. Phone/Fax

Practice location:
  • Phone: 801-479-3346
  • Fax: 801-479-0725
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-1045
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number10343236
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA-1045
License Number StateWY
# 4
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number10343236-4101
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: