# BRANDON MIHALICH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1013586866
- **Gender:** Man
- **Credential:** DDS, MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 30.027383 | OH | — |
| 122300000X | Dentist | D012728 | AZ | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 30.027383 | OH | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | D012728 | AZ | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 35.150020 | OH | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 79644 | AZ | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | Yes |

## Other

- **Enumeration date:** 06/24/2021
- **Last updated:** 03/17/2026