Provider Demographics
NPI:1043405095
Name:TODD DAYNES, MD, PC
Entity Type:Organization
Organization Name:TODD DAYNES, MD, PC
Other - Org Name:DAYNES EYE AND LASIK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-671-8530
Mailing Address - Street 1:280 S MAIN ST STE 155
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6236
Mailing Address - Country:US
Mailing Address - Phone:801-505-0821
Mailing Address - Fax:
Practice Address - Street 1:1250 E 3900 S STE 310
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1350
Practice Address - Country:US
Practice Address - Phone:801-263-2020
Practice Address - Fax:801-263-2229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5842999-1205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT529479193002Medicaid
UTI34498Medicare UPIN