Provider Demographics
NPI:1326024670
Name:TINER, BRANDI LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:LYNN
Last Name:TINER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:BRANDI
Other - Middle Name:LYNN
Other - Last Name:TINER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5717 E THOMAS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7620
Mailing Address - Country:US
Mailing Address - Phone:480-607-9999
Mailing Address - Fax:
Practice Address - Street 1:5867 N MESA ST
Practice Address - Street 2:STE B
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4677
Practice Address - Country:US
Practice Address - Phone:915-504-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21113122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist