Provider Demographics
NPI:1073622817
Name:BESS, JOHN SHEA (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:SHEA
Last Name:BESS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3556 WEST 9800 SOUTH
Mailing Address - Street 2:STE 102
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095
Mailing Address - Country:US
Mailing Address - Phone:801-280-5558
Mailing Address - Fax:801-446-9818
Practice Address - Street 1:3556 WEST 9800 SOUTH
Practice Address - Street 2:STE 102
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095
Practice Address - Country:US
Practice Address - Phone:801-280-5558
Practice Address - Fax:801-446-9818
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5110182122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist