Provider Demographics
NPI:1134323280
Name:RANVEK, BRANDON J (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:J
Last Name:RANVEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14895 S ROBERT TRL
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-3108
Mailing Address - Country:US
Mailing Address - Phone:952-423-2288
Mailing Address - Fax:952-423-2203
Practice Address - Street 1:14895 S ROBERT TRL
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-3108
Practice Address - Country:US
Practice Address - Phone:952-423-2288
Practice Address - Fax:952-423-2203
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND124031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice