MEDICARE: DR. CHRISTOPHER S BRENDEMUHL DMD

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	1223G0001X	General Practice Dentistry	D7404	AZ

General Provider Information

NPI Number	:	1780872390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER S BRENDEMUHL DMD

Provider Business Mailing Address
First Line	:	PO BOX 29670
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85038-9670
Country	:	US
Telephone Number	:	602-344-8181
Fax Number	:	602-344-8122

Provider Business Practice Location Address
First Line	:	1101 N CENTRAL AVE STE 106
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1808
Country	:	US
Telephone Number	:	602-344-8717
Fax Number	:	602-344-8722

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

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	01/10/2020

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