Provider Demographics
NPI:1295843811
Name:JOYNER, BRANDY THORNTON (DDS)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:THORNTON
Last Name:JOYNER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 SILAS CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5147
Mailing Address - Country:US
Mailing Address - Phone:336-777-0303
Mailing Address - Fax:336-777-3448
Practice Address - Street 1:3212 S WILMINGTON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-3538
Practice Address - Country:US
Practice Address - Phone:919-773-3002
Practice Address - Fax:919-773-8824
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
9021KOtherBLUE CROSS BLUE SHIELD NC
NC5901039Medicaid