Healthcare Provider Details

I. General information

NPI: 1669059028
Provider Name (Legal Business Name): AUSTIN PAUL DINKEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4403 HARRISON BLVD STE 700A
OGDEN UT
84403-3295
US

IV. Provider business mailing address

13967 JASMINE ST
THORNTON CO
80602-9112
US

V. Phone/Fax

Practice location:
  • Phone: 801-387-5300
  • Fax: 801-387-5333
Mailing address:
  • Phone: 801-387-5300
  • Fax: 801-387-5333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0074121
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16910A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: