Provider Demographics
NPI:1265729644
Name:STROOPE, BRANDON RAY (DMD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:RAY
Last Name:STROOPE
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 1:3860 HIGHWAY 412 E STE F
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-8499
Mailing Address - Country:US
Mailing Address - Phone:479-306-6433
Mailing Address - Fax:479-524-0976
Practice Address - Street 1:3860 HIGHWAY 412 E STE F
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761
Practice Address - Country:US
Practice Address - Phone:479-306-6433
Practice Address - Fax:479-524-0976
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3825122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR191410608Medicaid