Healthcare Provider Details

I. General information

NPI: 1578468815
Provider Name (Legal Business Name): MR. NICHOLAS MICHAEL CROWTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10894 S RIVER FRONT PKWY
SOUTH JORDAN UT
84095-5609
US

IV. Provider business mailing address

1664 DARLING ST
OGDEN UT
84403-0559
US

V. Phone/Fax

Practice location:
  • Phone: 801-878-1233
  • Fax:
Mailing address:
  • Phone: 801-644-9935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberAEGD1564
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: