Healthcare Provider Details

I. General information

NPI: 1326348046
Provider Name (Legal Business Name): ANDREW N BITTER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1943 N STATE ST
OREM UT
84057-2028
US

IV. Provider business mailing address

1943 N STATE ST
OREM UT
84057-2028
US

V. Phone/Fax

Practice location:
  • Phone: 801-226-0441
  • Fax: 801-226-4754
Mailing address:
  • Phone: 801-226-0441
  • Fax: 801-226-4754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9158504
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6665-15
License Number StateWI

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: