Provider Demographics
NPI:1861781031
Name:STAPLETON, BRANDON MORRIS (DMD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:MORRIS
Last Name:STAPLETON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 DARBY CREEK ROAD SUITE 190
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2710
Mailing Address - Country:US
Mailing Address - Phone:606-205-6949
Mailing Address - Fax:
Practice Address - Street 1:541 DARBY CREEK ROAD STE 190
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1701
Practice Address - Country:US
Practice Address - Phone:859-287-2484
Practice Address - Fax:859-287-2463
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY90381223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty