IndividualActive
Dustin Wise, M.D.
NPI 1811945769 · Pediatrics Physician · Pleasant Grove, UT
Provider details
- NPI number
- 1811945769
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 52479661205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
1888 W 800 N
Pleasant Grove, UT 84062-4097
Phone: (801) 492-7851
Fax: (801) 492-7883
Street-level locationGet directions
Mailing address
1888 W 800 N
Pleasant Grove, UT 84062
Registry dates
- Enumerated
- 2006-05-04
- Last updated
- 2021-09-09
- Certified
- 2021-09-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.