Davis, Brenden J
Davis, Brenden J is an sole proprietor health care provider with primary practice located at 910 S Columbia Center Blvd Ste D , Kennewick WA 99336-9560. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Davis, Brenden J can be contacted via phone (509) 607-1872.Contact Information
Primary practice address
910 S Columbia Center Blvd Ste D
Kennewick WA 99336-9560
Phone: (509) 607-1872
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DE60103956 | Washington |
| Dental Providers / Dentist | 122300000X | DE60103956 | Washington |
Profile Details
| NPI number | 1538391040 |
|---|---|
| LBN Legal business name | Davis, Brenden J |
| Credentials | DMD, MPH |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2009 |
| Last updated | Aug 4th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538391040 | NPPES |
| Washington | Other | 0255549 | LABOR & INDUSTRIES |
| Washington | MEDICAID | 5060215 | LABOR & INDUSTRIES |
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