Individual provider Active NPI

Evan William Brown, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Saint Charles, MO
National Provider Identifier
1003177783
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
41367 Issued in MO
Practice address
1 Garvey Pkwy Ste 200
Saint Charles, MO 63303
Phone
(636) 441-2777
NPI assigned
May 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 63401 CA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 41367 MO Primary

Addresses

Primary practice location

1 Garvey Pkwy Ste 200
Saint Charles, MO 63303

Mailing address

1 Garvey Pkwy Ste 200
Saint Charles, MO 63303-5615
Phone (248) 840-5619

Other practice location 1

6766 Bernal Ave # 560
Pleasanton, CA 94566-1218
Phone (248) 840-5619

Other practice location 2

160 Four Seasons Shopping Ctr
Chesterfield, MO 63017-3104
Phone (314) 469-0964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41367MOMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Evan W Brown DDS Inc Orthodontics and Dentofacial Orthopedics Current Accepting new patients

Locations

160 Four Seasons Shopping Ctr
Chesterfield, MO 63017
Phone (314) 469-0964

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1003177783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GARVEY PKWY STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035615",
            "telephone_number": "248-840-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GARVEY PKWY STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "63303",
            "telephone_number": "636-441-2777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6766 Bernal Ave # 560",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "CA",
            "postal_code": "945661218",
            "country_code": "US",
            "telephone_number": "248-840-5619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 Four Seasons Shopping Ctr",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630173104",
            "country_code": "US",
            "telephone_number": "314-469-0964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "EVAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-30",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "63401",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "41367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.