Healthcare Provider Details

I. General information

NPI: 1326308438
Provider Name (Legal Business Name): FRANK REGGIE WHITAKER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4902 S 1900 W STE 4
ROY UT
84067-4000
US

IV. Provider business mailing address

4902 S 1900 W STE 4
ROY UT
84067-4000
US

V. Phone/Fax

Practice location:
  • Phone: 801-776-2806
  • Fax:
Mailing address:
  • Phone: 435-563-3025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number83077979922
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: