Healthcare Provider Details

I. General information

NPI: 1730029935
Provider Name (Legal Business Name): AMRITPAL BADWALZ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10894 S. RIVER FRONT PKWY SOUTH JORDAN
SOUTH JORDAN UT
84095
US

IV. Provider business mailing address

10894 S. RIVER FRONT PKWY SOUTH JORDAN
SOUTH JORDAN UT
84095
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: