IndividualActive
Jake Richardson, D.M.D.
NPI 1568024347 · General Practice Dentistry · Fort Duchesne, UT
Provider details
- NPI number
- 1568024347
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- D.M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 11308205-9921 (UT)
Specialties & taxonomies
Dental Providers
Practice location
6932 E 1400 S
Fort Duchesne, UT 84026
Phone: (435) 722-5122
Approximate (ZIP-level) locationGet directions
Mailing address
412 E 2500 N
Vernal, UT 84078-9595
Registry dates
- Enumerated
- 2019-07-02
- Last updated
- 2019-07-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.