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Deactivated NPI 1679626857 Deactivated / Inactive NPI Male Practitioner

Dr. Carl A. Dickerson , DDS

Dentist - General Practice • Roy, UT

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Carl Dickerson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 19, 2007
NPI Deactivation Date June 18, 2018
Total Practice Duration ~11 Years of Practice (2007 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Carl Dickerson, DDS was a registered Dentist - General Practice practicing in Roy, UT. Throughout an active medical career spanning 11 years, Dr. Dickerson provided care at the practice location at 5133 S 1900 W until profile deactivation on 2018-06-18.

Practice Location & Contact Primary Location

Practice Address

5133 S 1900 W

Roy, UT 840672926

Telephone 8017737733
Fax 8017731932

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Roy, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
25 Specialists

Practicing in Roy, UT (1388 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License UT 135161-

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 18, 2018

Record deactivated on June 18, 2018

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 5133 S 1900 W, ROY, UT 840672926 (Tel: 8017737733)

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Updated Business Mailing Address July 08, 2007

Registered at 5133 S 1900 W, ROY, UT 840672926 (Tel: 8017737733)

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Provider Name / Credentials Updated July 08, 2007

Recorded as CARL DICKERSON, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #135161- in UT)

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Initial NPI Registration & Enumeration January 19, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1679626857
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 19, 2007
Last Update: July 08, 2007
Deactivation Date: June 18, 2018

Mailing Address

5133 S 1900 W

Roy, UT 840672926

Phone: 8017737733

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.