Healthcare Provider Details

I. General information

NPI: 1568307775
Provider Name (Legal Business Name): BRANDON L NASH DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5345 N EL DORADO ST STE 1
STOCKTON CA
95207-5848
US

IV. Provider business mailing address

5345 N EL DORADO ST STE 1
STOCKTON CA
95207-5848
US

V. Phone/Fax

Practice location:
  • Phone: 209-952-1561
  • Fax: 209-952-2962
Mailing address:
  • Phone: 209-952-1561
  • Fax: 209-952-2962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. BRANDON L NASH
Title or Position: PRESIDENT
Credential: DDS
Phone: 209-952-1561