Provider Demographics
NPI:1508488008
Name:DEXA BODY INC
Entity Type:Organization
Organization Name:DEXA BODY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-428-8350
Mailing Address - Street 1:5263 S COMMERCE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5306
Mailing Address - Country:US
Mailing Address - Phone:801-274-3392
Mailing Address - Fax:801-274-3392
Practice Address - Street 1:5263 S COMMERCE DR STE 201
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5306
Practice Address - Country:US
Practice Address - Phone:801-274-3392
Practice Address - Fax:801-274-3392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2022-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Single Specialty