Healthcare Provider Details

I. General information

NPI: 1639009665
Provider Name (Legal Business Name): BRANDON LEE HARDING DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 CAPEHART RD
BELLEVUE NE
68123
US

IV. Provider business mailing address

7910 N 86TH AVE
OMAHA NE
68122-1288
US

V. Phone/Fax

Practice location:
  • Phone: 402-232-2273
  • Fax:
Mailing address:
  • Phone: 208-540-0821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: