OrganizationActive
Utah Modern Medical LLC
NPI 1689310948 · General Practice Physician · Lehi, UT
Provider details
- NPI number
- 1689310948
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Dave Bullock, Owner(385) 455-7170
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Medical Physician Assistant363AM0700X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
3300 N Ashton Blvd
Ste 450
Lehi, UT 84043-6153
Phone: (385) 455-7170
Fax: (888) 823-5887
Street-level locationGet directions
Mailing address
3300 N Ashton Blvd
Lehi, UT 84043-6153
Registry dates
- Enumerated
- 2022-05-10
- Last updated
- 2025-02-10
- Certified
- 2025-02-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.