Provider Demographics
NPI:1366270134
Name:GARRETT, BRADY STEVEN (DDS)
Entity type:Individual
Prefix:DR
First Name:BRADY
Middle Name:STEVEN
Last Name:GARRETT
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 1:25885 N 93RD AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1257
Mailing Address - Country:US
Mailing Address - Phone:480-384-0588
Mailing Address - Fax:
Practice Address - Street 1:15009 W BELL RD STE 175
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3247
Practice Address - Country:US
Practice Address - Phone:623-476-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0122311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice