Dermatology Center Of Salt Lake Inc.

LBN: Dermatology Center Of Salt Lake Inc.
Dermatology Center Of Salt Lake Inc. is an health care organization with primary practice located at 7396 Union Park Ave #201, Midvale UT 84047-6700. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Dermatology Center Of Salt Lake Inc. can be contacted via phone (801) 567-1400, or through Jensen, Joseph D via phone (801) 567-1400.

Contact Information

Primary practice address
7396 Union Park Ave #201 Midvale UT 84047-6700
Fax: (801) 567-1777
Website:
Authorized official contact:
Name: Jensen, Joseph D Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 266561-1205 Utah

Profile Details

NPI number 1689635799
LBN Legal business name Dermatology Center Of Salt Lake Inc.
DBA Doing business as
Authorized official Jensen, Joseph D Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 29th, 2006
Last updated Apr 15th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689635799 NPPES
Utah Other QM0000046926 ALTIUS
Utah MEDICAID 528986681031 ALTIUS
Utah Other 52898668108001 ALTIUS
Utah Other 107007222102 ALTIUS

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