BRANDON JOLLEY DDS PA LLC NPI 1104691096

NPI Information

  • NPI: 1104691096
  • Provider Name: BRANDON JOLLEY DDS PA LLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: EVERGREEN WOODS DENTISTRY
  • Address: 700 MOUNT HOPE AVE STE 610
    BANGOR, ME
    ZIP 04401
  • Phone: (207) 945-5952

Map and Directions

Get Directions

NPI Details

BRANDON JOLLEY DDS PA LLC is a general practice dentist in Bangor, ME. The provider is 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. BRANDON JOLLEY DDS PA LLC NPI is 1104691096. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Evergreen Woods Dentistry.

The provider's business location address is:

700 MOUNT HOPE AVE STE 610
BANGOR, ME
ZIP 04401-673
Phone: (207) 945-5952
Fax: (207) 945-5761

The provider's authorized official is Brandon Jolley .
The authorized official title is Owner/dentist and has the following contact phone number (505) 401-4923.

The enumeration date for this NPI number is 11/20/2023 and was last updated on 11/28/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.