Healthcare Provider Details

I. General information

NPI: 1225598758
Provider Name (Legal Business Name): BRANDON JACOB SAXE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 OAK ST STE 101W
BROCKTON MA
02301-1168
US

IV. Provider business mailing address

830 OAK ST STE 101W
BROCKTON MA
02301-1168
US

V. Phone/Fax

Practice location:
  • Phone: 508-586-5445
  • Fax:
Mailing address:
  • Phone: 508-586-5445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN1860064
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: