Individual provider Active NPI

Eric Randall Brannon, DDS

  • General Practice Dentistry
  • Spencer, WV
National Provider Identifier
1659336246
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
WV2812 Issued in WV
Practice address
350 Hospital Dr
Spencer, WV 25276-1049
Phone
(304) 927-2775
Fax
(304) 927-2777
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X WV2812 WV Primary

Addresses

Primary practice location

350 Hospital Dr
Spencer, WV 25276-1049

Mailing address

350 Hospital Dr
Spencer, WV 25276-1049
Phone (304) 927-2775

Other identifiers 3

IdentifierTypeStateIssuer
00831460OtherWVBLUE CROSS
0137324000MedicaidWV
1535747OtherWVUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2017 through Jan 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WV2812WVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Brannon Dental Associates PLLC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1659336246",
    "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": {
        "last_name": "BRANNON",
        "first_name": "ERIC",
        "middle_name": "RANDALL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "WV2812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00831460",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137324000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1535747",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, WV

Sources for this page

Verify at the official NPI Registry.