104 West Dental LLC
NPI 1255294765ActiveOrganization· Dentist, General Practice· Brigham City, UT
Dentist, General Practice in Brigham City, Utah, registered in NPPES in December 2025. The authorized official on file is Daniel Nelson, DDS, Member.
Overview
| NPI | 1255294765 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 3, 2025 |
| Last updated in NPPES | Dec 3, 2025 |
| Certified by provider | Dec 3, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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