Unknown Individual – Dentist, NPI 1265592075

Unknown Individual is a healthcare provider. based in Bountiful, Utah. specializing in Dentist. They hold a License No. 1255909921 (UT). The NPI Number for Unknown Individual is 1265592075

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1265592075
Phone
(801) 295-1198
Address
415 SO MEDICAL DRIVE
Deactivation Date
30 August 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Medical Drive, Bountiful, Davis County, Utah, 84010, United States

    STE B 100

    BOUNTIFUL, UT 840104992

    Phone: (801) 295-1198

    Fax: (801) 295-5981

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84010)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1265592075 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Dentist. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Bountiful, Utah because that is what the record indicates for Unknown Individual.
What if Bountiful, Utah seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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