Provider Demographics
NPI:1164787040
Name:BRENNAN, JAMES ELLIOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ELLIOTT
Last Name:BRENNAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 E RAY RD
Mailing Address - Street 2:STE 2
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8722
Mailing Address - Country:US
Mailing Address - Phone:480-498-8825
Mailing Address - Fax:
Practice Address - Street 1:1929 E RAY RD
Practice Address - Street 2:STE 2
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-8722
Practice Address - Country:US
Practice Address - Phone:480-498-8825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-07
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0085011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice