Brannon & Brannon a Professional Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

22048 Issued in CA

Legal business name

BRANNON & BRANNON A PROFESSIONAL CORPORATION

Practice address

15525 Pomerado Road
Suite C6
Poway, CA 92064-2426

Phone

(858) 485-6600

Fax

(858) 673-5546

NPI assigned

Apr 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wayne Alan Brannon, DDS

Title

President

Phone

(858) 485-6600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184686842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15525 POMERADO ROAD",
            "address_2": "SUITE C6",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642426",
            "telephone_number": "858-485-6600",
            "fax_number": "858-673-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15525 POMERADO ROAD",
            "address_2": "SUITE C6",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642426",
            "telephone_number": "858-485-6600",
            "fax_number": "858-673-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANNON & BRANNON A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRANNON",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-485-6600",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "22048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.