BRANDON MODERN DENTISTRY, PA (NPI# 1831744655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831744655 |
| Entity Type | Organization |
| Organization Name | BRANDON MODERN DENTISTRY, PA |
| Practice Address |
971 E. Bloomingdale Avenue Brandon FL 33511 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 8134353867 |
| Practice Fax Number | 8134657538 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 3039520892 |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-08-08 |
| Authorized Official Name | MINH B PHAM (OWNER) |
| Authorized Official Telephone | 8134353867 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Brandon Modern Dentistry | Doing Business As Name - Organization |
| Street Address |
971 E. BLOOMINGDALE AVENUE |
| City | BRANDON |
| State | FL |
| Zip Code | 33511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295367555 | Ability Beyond Measures LLC. | Clinic/Center | 2705 Isabella Valley Court, Brandon, FL 33511 | 2020-02-05 |
| 1487208922 | Heart and Vascular Center of Brandon, Pllc | Internal Medicine | 511 Medical Oaks Ave., Brandon, FL 33511 | 2019-08-01 |
| 1841842895 | Rebecca Harrelson | Counselor | 915 Oakfield Drive, Suite E, Brandon, FL 33511 | 2019-07-10 |
| 1043779713 | Cheryl Diane Hart | Nurse Practitioner | 888 S Parsons Ave., Brandon, FL 33511 | 2019-03-13 |
| 1306303177 | Paula J Buchwald | Nurse Practitioner | 888 S. Parsons Ave, Brandon, FL 33511 | 2019-02-27 |
| 1063993996 | Ashlee Marie Shevchenko | Speech-Language Pathologist | 602 Vondeburg Dr, Suite 201, Brandon, FL 33511 | 2018-08-28 |
| 1275023012 | Ava Cares, LLC | Assisted Living Facility | 3005 Bell Shoals Rd., Brandon, FL 33511 | 2018-05-17 |
| 1346738705 | Tampa Psychology Group | Psychologist | 1463 Oakfield Dr Ste 109, Brandon, FL 33511 | 2018-05-01 |
| 1760982987 | Suresh Lama Tamang | Counselor | 510 Vonderburg Dr, Suite# 301, Brandon, FL 33511 | 2018-02-14 |
| 1538672787 | Brandon Smiles LLC | Dentist | 926 West Lumsden Rd, Brandon, FL 33511 | 2017-11-09 |
| Find all providers in zip 33511 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255955340 | Terah Shelby | Dentist | 2139 Highway 471, Brandon, MS 39047-8748 | 2020-06-03 |
| 1992368112 | Donna Mansour | Dentist | 971 E Bloomingdale Ave, Brandon, FL 33511-8118 | 2019-04-15 |
| 1538672787 | Brandon Smiles LLC | Dentist | 926 West Lumsden Rd, Brandon, FL 33511 | 2017-11-09 |
| 1770009649 | Arnold Dentistry, Pa | Dentist | 330 E Bloomingdale Ave, Brandon, FL 33511-8155 | 2017-08-22 |
| 1679003768 | Jay Ghiya | Dentist | 10955 Causeway Blvd, Brandon, FL 33511-1997 | 2017-06-13 |
| 1497106033 | Affiliated Dental Specialist | Dentist | 2488 W Brandon Blvd Ste B, Brandon, FL 33511-4710 | 2016-06-24 |
| 1699150110 | Shadan Hafsa | Dentist | 611 E Bloomingdale Ave Ste C, Brandon, FL 33511-8127 | 2015-07-26 |
| 1427439835 | Daniel Ray Carney | Dentist | 100 Avalon Ct Ste A, Brandon, MS 39047-7672 | 2015-06-11 |
| 1770982183 | Maria Yatzkan | Dentist | 2118 W Brandon Blvd., Brandon, FLORIDA 33511 | 2014-08-21 |
| 1760738967 | Krivarchka Family Dentistry P.C. | Dentist | 1511 W Holly Blvd, Brandon, SD 57005-2658 | 2012-07-25 |
| Find all providers in BRANDON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.