Provider Demographics
NPI:1275978132
Name:CANFIELD, BRANDON SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:SCOTT
Last Name:CANFIELD
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 1:815 NEIL AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1342
Mailing Address - Country:US
Mailing Address - Phone:614-286-1513
Mailing Address - Fax:
Practice Address - Street 1:1601 N MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1632
Practice Address - Country:US
Practice Address - Phone:740-521-4142
Practice Address - Fax:740-785-5196
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0239221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice