Healthcare Provider Details

I. General information

NPI: 1841470804
Provider Name (Legal Business Name): DOROTA JOANNA LEBIEDZ-ODROBINA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 S MARIO CAPECCHI DR
SALT LAKE CITY UT
84112-5888
US

IV. Provider business mailing address

30 S MARIO CAPECCHI DR
SALT LAKE CITY UT
84112-5888
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-4333
  • Fax:
Mailing address:
  • Phone: 801-581-4333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number8785152
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: