Healthcare Provider Details

I. General information

NPI: 1730096314
Provider Name (Legal Business Name): ORNELA BASHAJ BAILEY RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9012 S HUCKLEBERRY CT
SANDY UT
84093-2679
US

IV. Provider business mailing address

9012 S HUCKLEBERRY CT
SANDY UT
84093-2679
US

V. Phone/Fax

Practice location:
  • Phone: 801-971-2830
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number6201603-4901
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: