Provider Demographics
NPI:1821510892
Name:MAGANA, BRANDI ALEXANDRIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:ALEXANDRIA
Last Name:MAGANA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6237 CAROLINA COMMONS DR STE 330
Mailing Address - Street 2:
Mailing Address - City:INDIAN LAND
Mailing Address - State:SC
Mailing Address - Zip Code:29707-6014
Mailing Address - Country:US
Mailing Address - Phone:803-547-9786
Mailing Address - Fax:
Practice Address - Street 1:6237 CAROLINA COMMONS DR STE 330
Practice Address - Street 2:
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707-6014
Practice Address - Country:US
Practice Address - Phone:803-547-9786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8944122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist