Provider Demographics
NPI:1386932663
Name:BRASHER, JOSHUA V (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:V
Last Name:BRASHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 E DANFORTH RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3201
Mailing Address - Country:US
Mailing Address - Phone:405-359-9696
Mailing Address - Fax:405-359-0808
Practice Address - Street 1:1333 E DANFORTH RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3201
Practice Address - Country:US
Practice Address - Phone:405-359-9696
Practice Address - Fax:405-359-0808
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6256122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist