Provider Demographics
NPI:1801236591
Name:SEXTON, BRENT E (DDS)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:E
Last Name:SEXTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 E GATE WAY APT 108
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-3543
Mailing Address - Country:US
Mailing Address - Phone:317-496-3776
Mailing Address - Fax:
Practice Address - Street 1:299 JUANA AVE STE E
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4838
Practice Address - Country:US
Practice Address - Phone:317-496-3776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA621431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics