Provider Demographics
NPI:1265280812
Name:ORTON, DUSTIN SCOTT
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:SCOTT
Last Name:ORTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 N 4475 W
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-8025
Mailing Address - Country:US
Mailing Address - Phone:435-559-4720
Mailing Address - Fax:
Practice Address - Street 1:3922 N MINERSVILLE HWY
Practice Address - Street 2:
Practice Address - City:ENOCH
Practice Address - State:UT
Practice Address - Zip Code:84721-7224
Practice Address - Country:US
Practice Address - Phone:435-267-4212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTINTERN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health