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104 WEST DENTAL LLC
NPI 1255294765
Dentist - General Practice in Brigham City, UT

Active since December 03, 2025
104 W 200 S, BRIGHAM CITY, UT 84302(435) 734-2394(435) 734-0117 Get Directions Write a Review

NPPES record last updated: December 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About 104 West Dental Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

104 WEST DENTAL LLC (NPI 1255294765) is a healthcare organization registered as a general practice in Brigham City, Utah and active in the NPI registry since December 2025. The organization lists Daniel Nelson, Member, as its authorized official.

NPPES Registry Identity

NPI1255294765
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business Name104 WEST DENTAL LLC
Location Address104 W 200 SBrigham City, UT 84302-2506
Mailing Address104 W 200 SBrigham City, UT 84302-2506 · (435) 734-2394 · Fax (435) 734-0117
Phone(435) 734-2394
Fax(435) 734-0117
Organization SubpartNo
Authorized OfficialDaniel NelsonMember · (435) 734-2394
Enumeration DateDecember 3, 2025
NPPES CertifiedDecember 3, 2025
✔ NPI 1255294765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
104 W 200 S, Brigham City, UT 84302
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HOWARD RAINEY DAINES D.D.S.
Dentist (General Practice)
104 W 200 S
BRIGHAM CITY, UT 84302
Box Elder County (435) 734-2394
DR. DANIEL KEITH NELSON D.D.S.
Dentist (General Practice)
104 W 200 S
BRIGHAM CITY, UT 84302
Box Elder County (435) 734-2394

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 104 West Dental LLC's NPI number?

The NPI number for 104 West Dental LLC is 1255294765. It was assigned to this organization in the NPPES registry on December 3, 2025.

Where is 104 West Dental LLC located?

104 West Dental LLC is located at 104 W 200 S, Brigham City, UT 84302. The listed phone number is (435) 734-2394.

What is 104 West Dental LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for 104 West Dental LLC was last updated on December 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.