Provider Demographics
NPI:1912357351
Name:KARIYA, BRYAN (DDS)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:KARIYA
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 1:4529 HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MORGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84050-6799
Mailing Address - Country:US
Mailing Address - Phone:801-725-6291
Mailing Address - Fax:
Practice Address - Street 1:2779 W 4000 S
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-9603
Practice Address - Country:US
Practice Address - Phone:801-731-5528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6841122300000X
UT10301292-8903122300000X
UT10301292-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist