Healthcare Provider Details

I. General information

NPI: 1184410193
Provider Name (Legal Business Name): DAVID WILLIAM BRANDON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 S DAKOTA AVE
VANDENBERG AFB CA
93437-6307
US

IV. Provider business mailing address

338 S DAKOTA AVE
VANDENBERG AFB CA
93437-6307
US

V. Phone/Fax

Practice location:
  • Phone: 805-606-2273
  • Fax:
Mailing address:
  • Phone: 805-606-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number30.027930
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.027930
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: