DR. SHAD B MACKERT D.D.S. NPI 1144605403

NPI Information

NPI: 1144605403
Provider Name: DR. SHAD B MACKERT, D.D.S.
Classification: Dentist - 1223P0700X
Entity Type: Individual

Specialization: Prosthodontics

PECOS Registration: Yes

Address:
12459 S 300 E STE 202
DRAPER, UT
ZIP 84020
Phone: (385) 430-1200
Get Directions

DR. Shad B Mackert, D.D.S. is a prosthodontics dentist in Draper, UT. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. DR. Shad B Mackert, D.D.S. NPI is 1144605403. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12459 S 300 E STE 202
DRAPER, UT
ZIP 84020-899
Phone: (385) 430-1200

The NPI 1144605403 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/28/2015 and was last updated on 9/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0700X	Dentist	Prosthodontics	10220776-8903	UTAH	Yes
2	1223P0700X	Dentist	Prosthodontics	2901021479	MICHIGAN	No
3	1223G0001X	Dentist	General Practice	2901021479	MICHIGAN	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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