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Dallin L De Mordaunt

  • Male

Medical Specialty

Professional ID

  • NPI: 1336128388
  • PECOS ID: 5890723142
  • Enrollment ID: I20050728001003
  • Credential(MD, DO, DPM): MD
  • Medical School: George Washington University School Of Medicine
  • Medical School Graduation Year: 2001

Hospital Service

  • Hospital CCN1: 460041
  • Business Name (LBN)1: Davis Hospital And Medical Center
  • Hospital CCN2: 290001
  • Business Name (LBN)2: Renown Regional Medical Center
  • Hospital CCN3: 290049
  • Business Name (LBN)3: Renown South Meadows Medical Center

Medical Practices

  • Organization Name: Robert G Berry Jr Md Ltd
  • Group Practice ID assigned by PECOS: 2466488903
  • Number of Group Practice member: 6

Location

  • Address1: 6630 S Mccarran Blvd
  • Address2: Suite A4
  • City: Reno
  • State: Nevada
  • Zip Code: 89509
  • Phone Number: (775)828-2873

Medical Practices

  • Organization Name: Physician Group Of Utah Inc
  • Group Practice ID assigned by PECOS: 8022032234
  • Number of Group Practice member: 130

Location

  • Address1: 2132 N 1700 W
  • Address2: 230 Davis Orthopedics And Sports Medicine
  • City: Layton
  • State: Utah
  • Zip Code: 84041
  • Phone Number: (801)773-3900

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS):
  • Used Electronic health record (EHR): Yes