Provider Demographics
NPI:1245581016
Name:BIRRER, BRAMLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRAMLEY
Middle Name:
Last Name:BIRRER
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 1:16191 EAGLE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-2448
Mailing Address - Country:US
Mailing Address - Phone:714-316-8221
Mailing Address - Fax:
Practice Address - Street 1:9730 3RD AVE NE STE 205
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2023
Practice Address - Country:US
Practice Address - Phone:206-367-6453
Practice Address - Fax:877-261-7379
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101921223G0001X
CA615701223G0001X
WADE607456891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice