Organization Active NPI

M. Stephen Brandon, DDS LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Charleston, SC
National Provider Identifier
1124296470
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4281 Issued in SC
Legal business name
M. STEPHEN BRANDON, DDS LLC
Practice address
1051 Gardner Rd Ste B
Charleston, SC 29407-5747
Phone
(843) 769-7759
Fax
(843) 769-7761
NPI assigned
Feb 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Stephen Brandon, DDS
Title
Owner
Phone
(843) 769-7759

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 4281 SC Primary

Addresses

Primary practice location

1051 Gardner Rd Ste B
Charleston, SC 29407-5747

Mailing address

1051 Gardner Rd Ste B
Charleston, SC 29407-5747
Phone (843) 769-7759

National Provider Directory

National Provider Directory

Locations

1051 Gardner Rd
Ste B
Charleston, SC 29407
Phone (843) 571-5188

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1124296470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 GARDNER RD STE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075747",
            "telephone_number": "843-769-7759",
            "fax_number": "843-769-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 GARDNER RD STE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075747",
            "telephone_number": "843-769-7759",
            "fax_number": "843-769-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. STEPHEN BRANDON, DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "BRANDON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-769-7759",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "4281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.