Healthcare Provider Details

I. General information

NPI: 1912828849
Provider Name (Legal Business Name): BRANDON MICHAEL BARNES DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9020 SENCA DR STE 210
WILMINGTON NC
28411-6680
US

IV. Provider business mailing address

9020 SENCA DR STE 210
WILMINGTON NC
28411-6680
US

V. Phone/Fax

Practice location:
  • Phone: 910-756-5100
  • Fax: 336-594-0287
Mailing address:
  • Phone: 910-756-5100
  • Fax: 336-594-0287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14912
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: