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General NPI Number Information
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NPI Number | 1740411818
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Entity Type | Individual
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Provider Name | BRANDON JOSEPH STREIFF DMD
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Gender | Male
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 13957 S BANGERTER PKWY STE 101
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City | DRAPER
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State | UT
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Zip | 84020-5429
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Country | US
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Telephone | 385-799-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 1705 E WYLIE LN
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City | DRAPER
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State | UT
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Zip | 84020-7675
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Country | US
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Telephone | 801-891-7485
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 48103949921
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 4810394-9921
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License Number State | UT
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