MEDICARE: BRANDY EVANS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	0401418740	VA

General Provider Information

NPI Number	:	1447916952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDY EVANS DDS

Provider Business Mailing Address
First Line	:	2336 ELSON GREEN AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-6939
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2336 ELSON GREEN AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-6939
Country	:	US
Telephone Number	:	757-796-7846
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2021
Last Update Date	:	01/25/2026

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Directions to “ BRANDY EVANS DDS” Practice Location

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