Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DOMINIQUE SAGE ELDER
DeactivatedDOMINIQUE SAGE ELDER is a Student (Health Education/Training) healthcare provider located in PROVO, Utah. NPI 1063079705 is deactivated in the NPPES registry. Verify at CMS.
Student (Health Education/Training) · PROVO, UT
This NPI has been deactivated.
The record was deactivated on May 7, 2025.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1063079705
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 28, 2019 (5.9424657534247 yrs)
- Last Updated
- Jul 30, 2025
- Deactivated
- May 7, 2025
Practice Information
- Address
-
1800 S NOVELL PLACEPROVO, UT, 84606Browse UT providers · Browse ZIP 84606
- Phone
- 8018302038
- Primary Specialty
-
Student (Health Education/Training)
390200000X
Other Student (Health Education/Training) Providers in PROVO, UT
| Name | Credential | NPI |
|---|---|---|
| LILLIAM HENNINGSON | LCSW | 1225158967 |
| TYSON DEKORSE | M.D. | 1043421936 |
| DR. JEREMY MCCANDLESS | M.D. | 1174713424 |
| AMY CHERIE HOGLUND | BSWI | 1689844680 |
| LORNA ALLISON LAIRD | BSWI | 1609041144 |
| MARILYN TUCKER SOTO | MSWI | 1437324571 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.