Provider Demographics
NPI:1922624527
Name:EVERETT, BRITTANY JOELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:JOELL
Last Name:EVERETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 STAFFORD RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-2338
Mailing Address - Country:US
Mailing Address - Phone:317-839-2088
Mailing Address - Fax:
Practice Address - Street 1:1855 STAFFORD RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-2338
Practice Address - Country:US
Practice Address - Phone:317-839-2088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013405A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist