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NPI Code Detail

MEDICARE: BRENNAN HENNING DDS

MEDICARE:   BRENNAN  HENNING  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist11381NC
2122300000XDentistD010405AZ

General Provider Information

NPI Number : 1073172037
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENNAN HENNING DDS
Provider Business Mailing Address
First Line : 201 MCCULLOUGH DR STE 180
Second Line :
City : CHARLOTTE
State : NC
Zip : 28262-1302
Country : US
Telephone Number : 704-790-4402
Fax Number :
Provider Business Practice Location Address
First Line : 610 N ALMA SCHOOL RD STE 4
Second Line :
City : CHANDLER
State : AZ
Zip : 85224
Country : US
Telephone Number : 480-461-8683
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2019
Last Update Date : 01/28/2026

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Directions to “ BRENNAN HENNING DDS” Practice Location

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