Brannon Dental Associates PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WV2812 Issued in WV

Legal business name

BRANNON DENTAL ASSOCIATES PLLC

Practice address

350 Hospital Dr
Spencer, WV 25276-1049

Phone

(304) 927-2775

Fax

(304) 927-2777

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Randall S. Brannon, DDSNPI 1598178295

Title

Partner

Phone

(304) 927-2775

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randall Stephen Brannon, DDS

  • General Practice Dentistry
  • Spencer, WV
  • NPI 1598178295
  NPD (past) Authorized official
• Eric Randall Brannon, DDS

  • General Practice Dentistry
  • Spencer, WV
  • NPI 1659336246
  NPD (past)
• Regina Janet Brannon, DDS

  • General Practice Dentistry
  • Spencer, WV
  • NPI 1215992581
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451865600000",
    "number": "1275631871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 HOSPITAL DR",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761049",
            "telephone_number": "304-927-2775",
            "fax_number": "304-927-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HOSPITAL DR",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761049",
            "telephone_number": "304-927-2775",
            "fax_number": "304-927-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANNON DENTAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-01-04",
        "status": "A",
        "authorized_official_last_name": "BRANNON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "304-927-2775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "WV2812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005897",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Boggs
• Witney Faye Boswell
• Sierra Bowen
• Ryan Marshall Brabham, PTA
• Rachelle Brandenstein
• Eric Randall Brannon, DDS
• Randall Stephen Brannon, DDS
• Regina Janet Brannon, DDS
• Carly Marie Brohard, DPT
• Connie Sue Burdette

• General Practice Dentistry in Spencer, WV
• Providers in Spencer, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.