GREENWALT FAMILY DENTISTREE
NPI 1154770733
Dentist - General Practice in Jacksonville, FL

Q: What is Brandon Greenwalt Dmd PLLC's NPI number?

The NPI number for Brandon Greenwalt Dmd PLLC is 1154770733. It was assigned to this organization in the NPPES registry on June 6, 2016. The provider is doing business as Greenwalt Family Dentistree.

Q: What is Brandon Greenwalt Dmd PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since June 06, 2016

12443 SAN JOSE BLVD STE 101, JACKSONVILLE, FL 32223(904) 262-6188 Get Directions Write a Review

NPPES record last updated: June 6, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Greenwalt Family Dentistree NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREENWALT FAMILY DENTISTREE (NPI 1154770733) is a healthcare organization registered as a general practice in Jacksonville, Florida and active in the NPI registry since June 2016. The organization lists Brandon Lee Greenwalt, President, as its authorized official.

NPPES Registry Identity

NPI1154770733

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameBRANDON GREENWALT DMD PLLC

Location Address12443 SAN JOSE BLVD STE 101Jacksonville, FL 32223-8647

Mailing Address328 W Kari CtJacksonville, FL 32259-3320 · (317) 408-5764

Phone(904) 262-6188

Organization SubpartNo

Authorized OfficialBrandon Lee GreenwaltPresident · (317) 408-5764

Enumeration DateJune 6, 2016

✔ NPI 1154770733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in FL · DN19737

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

12443 SAN JOSE BLVD STE 101, Jacksonville, FL 32223

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Other Names 1

Doing Business AsGreenwalt Family Dentistree

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brandon Greenwalt Dmd PLLC's NPI number?

The NPI number for Brandon Greenwalt Dmd PLLC is 1154770733. It was assigned to this organization in the NPPES registry on June 6, 2016. The provider is doing business as Greenwalt Family Dentistree.

Where is Brandon Greenwalt Dmd PLLC located?

Brandon Greenwalt Dmd PLLC is located at 12443 San Jose Blvd Ste 101, Jacksonville, FL 32223. The listed phone number is (904) 262-6188.

What is Brandon Greenwalt Dmd PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Brandon Greenwalt Dmd PLLC accept?

Health plans from Ambetter Health and Ambetter of Alabama list Brandon Greenwalt Dmd PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brandon Greenwalt Dmd PLLC was last updated on June 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.