Provider Demographics
NPI:1902004179
Name:LOVING, BRANDY LEANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:LEANN
Last Name:LOVING
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:BRANDY
Other - Middle Name:LEANN
Other - Last Name:LISKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7800 N MOPAC EXPY STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8961
Mailing Address - Country:US
Mailing Address - Phone:512-649-4234
Mailing Address - Fax:512-436-0187
Practice Address - Street 1:7800 N MOPAC EXPY STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8961
Practice Address - Country:US
Practice Address - Phone:512-649-4234
Practice Address - Fax:512-649-4234
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX223121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry