Healthcare Provider Details

I. General information

NPI: 1225929011
Provider Name (Legal Business Name): ISABEL SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 S 1300 E STE L2
SALT LAKE CITY UT
84105-3675
US

IV. Provider business mailing address

1361 E MOSSY SPRINGS LN
MILLCREEK UT
84117-4731
US

V. Phone/Fax

Practice location:
  • Phone: 801-486-9649
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14275184
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: