Provider Demographics
NPI:1760040208
Name:BRINGHURST, SEAN L (DMD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:L
Last Name:BRINGHURST
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 1:3909 E BLUE SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-0433
Mailing Address - Country:US
Mailing Address - Phone:480-670-7106
Mailing Address - Fax:
Practice Address - Street 1:5505 S. LINDSAY RD. STE. 106
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:83201-4990
Practice Address - Country:US
Practice Address - Phone:480-670-7106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD010576122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDD-5028OtherIDAHO STATE BOARD OF DENTISTRY