Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brandon Greenwalt DMD PLLC

Organization General Practice Dentistry · NPI 1154770733

Brandon Greenwalt DMD PLLC is a General Practice Dentistry in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2016.

Licensed in
FL
In the registry since
2016
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12443 San Jose Blvd Ste 101
Jacksonville, FL 32223-8647
Phone: (904) 262-6188
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DN19737 (FL)

Record details

NPI number1154770733
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brandon Greenwalt — President · (317) 408-5764
Other names Greenwalt Family Dentistree
NPI enumeratedJune 6, 2016
Last updated in NPPESJune 6, 2016
Mailing address328 W Kari Ct, Jacksonville, FL 32259-3320

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