# BRIGHTSIDE DENTAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316613607
- **Authorized official:** BRANDY LOPEZ (VICE PRESIDENT OF OPERATIONS)
- **Authorized official phone:** (970) 596-8085

## Contact information

- **Practice address:** 4731 S COCHISE DR STE 110, INDEPENDENCE, MO 64055-6943
- **Practice address phone:** (816) 704-0818
- **Mailing address:** 4731 S COCHISE DR STE 110, INDEPENDENCE, MO 64055-6943
- **Mailing address phone:** (816) 704-0816

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/18/2021
- **Last updated:** 10/02/2025