Provider Demographics
NPI:1518275536
Name:RINEHART, BRANDON KENDALL (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:KENDALL
Last Name:RINEHART
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 N FRASER ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440-6407
Mailing Address - Country:US
Mailing Address - Phone:843-527-2081
Mailing Address - Fax:
Practice Address - Street 1:1729 N FRASER ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-6407
Practice Address - Country:US
Practice Address - Phone:843-527-2081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC69151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice