Healthcare Provider Details

I. General information

NPI: 1881953966
Provider Name (Legal Business Name): DAVID DENSLEY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2012
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROSEMAN UNIVERSITY 10920 S RIVER FRONT PKWY
SOUTH JORDAN UT
84095
US

IV. Provider business mailing address

8655 S MONROE ST
SANDY UT
84070-1406
US

V. Phone/Fax

Practice location:
  • Phone: 801-878-1200
  • Fax:
Mailing address:
  • Phone: 801-910-1167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8346823-9922
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: