Provider Demographics
NPI:1891990172
Name:HOFFMAN, BRIAN P (DMD,MPH)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:P
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DMD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 BEE RIDGE RD
Mailing Address - Street 2:BLDG. E, STE. D
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1207
Mailing Address - Country:US
Mailing Address - Phone:941-922-4546
Mailing Address - Fax:941-925-1734
Practice Address - Street 1:3920 BEE RIDGE RD
Practice Address - Street 2:BLDG. E, STE.D
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1207
Practice Address - Country:US
Practice Address - Phone:941-922-4546
Practice Address - Fax:941-925-1734
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17983122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN17983OtherDENTAL LICENSE
FL1981990172OtherEIN
FL1981990172OtherEIN