Provider Demographics
NPI:1841850278
Name:SCHLEYER, BRENDAN ANDREW (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:ANDREW
Last Name:SCHLEYER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 UNIVERSITY AVE SE APT 906
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-4441
Mailing Address - Country:US
Mailing Address - Phone:505-463-2189
Mailing Address - Fax:
Practice Address - Street 1:12611 MONTGOMERY BLVD NE
Practice Address - Street 2:SUITE A-1
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111
Practice Address - Country:US
Practice Address - Phone:505-463-2189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14308122300000X
NMDD55821223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist