Healthcare Provider Details

I. General information

NPI: 1568286466
Provider Name (Legal Business Name): BRANDON LINN ORTHODONTICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 VILLAGE SQUARE LN STE 100
CASTLE PINES CO
80108-3656
US

IV. Provider business mailing address

6660 TIMBERLINE RD STE 260
HIGHLANDS RANCH CO
80130-5345
US

V. Phone/Fax

Practice location:
  • Phone: 303-688-9617
  • Fax:
Mailing address:
  • Phone: 303-941-2011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. BRANDON LINN
Title or Position: PRESIDENT
Credential: DDS, MS
Phone: 303-941-2011