Provider Demographics
NPI:1780238592
Name:ERSTE, BRANDON (DMD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:ERSTE
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 1:34304 MARCUM BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44092-1332
Mailing Address - Country:US
Mailing Address - Phone:440-223-8331
Mailing Address - Fax:
Practice Address - Street 1:29010 CHARDON RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44092-1473
Practice Address - Country:US
Practice Address - Phone:440-944-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0259251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice