DERMATOLOGY CENTER OF SALT LAKE INC. NPI 1689635799

NPI Information

  • NPI: 1689635799
  • Provider Name: DERMATOLOGY CENTER OF SALT LAKE INC.
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 46D0972534
  • Address: 7396 UNION PARK AVE
    #201
    MIDVALE, UT
    ZIP 84047
  • Phone: (801) 567-1400

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NPI Details

DERMATOLOGY CENTER OF SALT LAKE INC. is a specialist in Midvale, UT. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DERMATOLOGY CENTER OF SALT LAKE INC. NPI is 1689635799. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7396 UNION PARK AVE
#201
MIDVALE, UT
ZIP 84047-700
Phone: (801) 567-1400
Fax: (801) 567-1777

The provider's authorized official is Joseph D Jensen .
The authorized official title is Md/owner and has the following contact phone number (801) 567-1400.

The CLIA number assigned to this NPI record is 46D0972534 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/29/2006 and was last updated on 4/15/2019.

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
1174400000XSpecialist266561-1205UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1107007222102OTHERIHC
2528986681031MEDICAIDUTAH
352898668108001OTHERUTAHBLUE SHIELD
4QM0000046926OTHERUTAHALTIUS

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: 3/30/2025

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