Provider Demographics
NPI:1346801958
Name:BRANDT, GABRIELLE (DDS)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:BRANDT
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 1:8505 E ALAMEDA AVE UNIT 3538
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6073
Mailing Address - Country:US
Mailing Address - Phone:720-899-7314
Mailing Address - Fax:
Practice Address - Street 1:25791 E SMOKY HILL RD UNIT 10
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1793
Practice Address - Country:US
Practice Address - Phone:303-699-3221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204059122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist