DR. DAVID RAY DEDRICKSON (NPI# 1144222779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144222779 |
| Entity Type | Individual |
| Full Name | DR. DAVID RAY DEDRICKSON |
| Credential | M.D. |
| Practice Address |
1433 N 1075 W Ste 104 Farmington UT 84025-2746 |
| Mailing Address |
Po Box 25488 Salt Lake City UT 84125-0488 |
| Practice Telephone | 8012981300 |
| Practice Fax Number | 8012966199 |
| Mailing Telephone | 8004753698 |
| Mailing Fax Number | 8012966199 |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2019-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
184965-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | RR MEDICARE | P00651526 | 01 |
| NV | 100505581 | 05 | |
| UT | 10536 | 05 | |
| AZ | 922890 | 05 | |
| UT | RR MEDICARE | P00199660 | 01 |
| WY | 120727000 | 05 | |
| ID | 807116200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902147127 | David Dedrickson | Counselor | 11211 Se 82nd Ave, Suite O, Happy Valley, OR 97086-7624 | 2013-03-13 |
| Street Address |
1433 N 1075 W STE 104 |
| City | FARMINGTON |
| State | UT |
| Zip Code | 84025-2746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851670137 | Diane Love Bachman | Counselor | 1433 N 1075 W, Farmington, UT 84025-2746 | 2011-08-04 |
| 1750682688 | Focusing Energy Inc. | Social Worker | 1433 N 1075 W, Suite 120, Farmington, UT 84025-2746 | 2010-11-09 |
| 1366638405 | Florence Ann Nielsen | Social Worker | 1433 N 1075 W, Ste 120, Farmington, UT 84025-2746 | 2007-09-21 |
| 1144431107 | David F Wilson | Psychiatry & Neurology | 1433 N 1075 W, Ste 120, Farmington, UT 84025-2746 | 2007-05-24 |
| 1891862991 | Oakridge Dental | Dentist | 1433 N 1075 W, Suite 100, Farmington, UT 84025-2746 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013522200 | Kim Nguyen | Behavior Technician | 1148 N Wilow Wind Rd Unit 9, Farmington, UT 84025 | 2020-09-14 |
| 1164980181 | Adam Thomas Creer | Nurse Practitioner | 696 N 40 E Apt 2, Farmington, UT 84025 | 2019-03-08 |
| 1881100550 | Lindsay Case | Counselor | 1645 W 1440 N, Farmington, UT 84025 | 2017-12-18 |
| 1447707955 | Joseph Daniel Levie | Chiropractor | 63 N. Main Street, Farmington, UT 84025 | 2016-09-01 |
| 1649724139 | University of Utah Adult Services | Dermatology | 165 N. University Ave. Farmington, Farmington, UT 84025 | 2016-08-12 |
| 1679931075 | Rhodes Physical Therapy, Inc | Clinic/Center | 722 W. Shepard Lane Suite 105, Farmington, UT 84025 | 2016-02-01 |
| 1760847552 | Polished Holdings, Inc. | Specialist | 491 W. Bourne Circle, Suite 2, Farmington, UT 84025 | 2015-12-21 |
| 1568833911 | Ageless Men's Health Holdings, LLC | Specialist | 491 West Bourne Circle, Suite 2, Farmington, UT 84025 | 2015-10-12 |
| 1588053300 | Onsyte Surgical of Nevada, LLC | Clinic/Center | 1262 S 650 W Suite 1d, Farmington, UT 84025 | 2015-01-16 |
| 1568879872 | Laura Cook | Counselor | 1200 West Red Barn Lane, Farmington, UT 84025 | 2014-07-18 |
| Find all providers in zip 84025 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275987802 | Farmington Imaging Center, LLC | Radiology | 399 Farmington Ave Lowr 1, Farmington, CT 06032-1937 | 2016-04-20 |
| 1538521679 | Focus Point Diagnostics LLC | Radiology | 23337 Orchard Lake Rd, Farmington, MI 48336-3238 | 2016-03-28 |
| 1619103306 | Christopher Michael Garcia | Radiology | 23 Hidden Oak Dr, Farmington, CT 06032-2735 | 2009-06-08 |
| 1992715122 | Kenneth L Miller | Radiology | 1101 W Liberty, Parkland Health Center Dept of Radiology, Farmington, MO 63640 | 2006-08-09 |
| 1497761795 | Medical Diagnostic Services Ltd | Radiology | 657a W Maple, Farmington, NM 87401 | 2006-07-31 |
| 1336182393 | Lynne F Bliss | Radiology | 801 W. Maple, Farmington, NM 87401 | 2006-06-14 |
| 1073507596 | Joseph B Alley | Radiology | 111 Farmington Health Commons, Farmington, ME 04938-6144 | 2005-09-12 |
| 1841284783 | John R Webster | Radiology | 801 W Maple Street, Farmington, NM 87401 | 2005-09-07 |
| 1629075684 | Steven Brent Lee | Radiology | 1433 N 1075 W Ste 104, Farmington, UT 84025-2746 | 2005-07-06 |
| 1902430481 | Nrg-parkland LLC | Radiology | 1101 W Liberty St, Farmington, MO 63640-1921 | 2020-02-24 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 84025 |
Please comment or provide details below to improve the information on DR. DAVID RAY DEDRICKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.