Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SHAD B MACKERT, D.D.S.
Active Sole ProprietorPediatric Dentistry · DRAPER, UT
Registration Details
- NPI Number
- 1144605403
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 28, 2015 (10.761428547955 yrs)
- Last Updated
- Sep 19, 2023
- Licenses
-
10220776-8903 (UT)2901021479 (MI)2901021479 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12459 S 300 E STE 202DRAPER, UT, 840201899Browse UT providers · Browse ZIP 84020
- Phone
- 3854301200
- Primary Specialty
-
Pediatric Dentistry
1223P0700X
- Additional Specialty
- Pediatric Dentistry
- Additional Specialty
- General Dentistry
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.