IndividualActive
Bradley Wallace, DMD
NPI 1487546305 · General Practice Dentistry · Sandy, UT
Provider details
- NPI number
- 1487546305
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 14228509-9926 (UT)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
853 E 9400 S
Sandy, UT 84094-3655
Phone: (801) 572-5550
Street-level locationGet directions
Mailing address
5327 W Canary Grass Way
South Jordan, UT 84009-1399
Additional practice locations (1)
- 6065 S Fashion Blvd Ste 275Murray, UT 84107-5441Phone: (462) 880-1262
Registry dates
- Enumerated
- 2025-07-16
- Last updated
- 2025-07-16
- Certified
- 2025-07-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.