Active NPI
Brandon Michael Wainwright, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Moline, IL
National Provider Identifier
1497867519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 08297
- Practice address
- 604 35TH Avenue
Moline, IL 61265 - Phone
- (309) 762-8445
- Fax
- (309) 762-6421
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 08297 | IA | Primary |
| General Practice Dentistry | 1223G0001X | IL |
Addresses
Primary practice location
604 35TH Avenue
Moline, IL 61265
Mailing address
604 35TH Avenue
Moline, IL 61265
Phone (309) 762-8445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-026389 | IL | MD | General Practice Dentistry |
| 08297 | IA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1497867519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 35TH AVENUE",
"city": "MOLINE",
"state": "IL",
"postal_code": "61265",
"telephone_number": "309-762-8445",
"fax_number": "309-762-6421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 35TH AVENUE",
"city": "MOLINE",
"state": "IL",
"postal_code": "61265",
"telephone_number": "309-762-8445",
"fax_number": "309-762-6421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAINWRIGHT",
"first_name": "BRANDON",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IA",
"license": "08297",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
- Vortech Health Inc (Rexroth Chiropractic Clinic)
- Vroman Orthodontics, P.C. (Maura Milas Vroman, D.D.S., M.S.)
- Maura Josephine Vroman, D.D.S., M.S.
- Sheri Lynn Vroman, CRT, RCP
- Kelly Waack, DPT
- Wal-Mart Stores, Inc (Vision Center 30-2231)
- Walgreen Co (Walgreens #03633)
- Walgreen Co (Walgreens #5720)
- Walgreen Co (Walgreens #06067)
- Walgreen Co. (Walgreens #5720)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.