Provider Demographics
NPI:1174502553
Name:LEPENDU, ADRIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:
Last Name:LEPENDU
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 1:1081 RAYMOND RD
Mailing Address - Street 2:
Mailing Address - City:FRUIT HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84037-2249
Mailing Address - Country:US
Mailing Address - Phone:801-546-3789
Mailing Address - Fax:801-546-3789
Practice Address - Street 1:47 CRESTWOOD RD
Practice Address - Street 2:SUITE 3
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-1445
Practice Address - Country:US
Practice Address - Phone:801-544-4204
Practice Address - Fax:801-546-6140
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5794640-9921122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist