David J Brown, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5318015 Issued in WI

Practice address

400 S Townline Road
Box 1440
Wautoma, WI 54982

Phone

(920) 787-5514

Fax

(920) 787-4737

NPI assigned

Mar 28, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• La Clinica de Los Campesinos, Inc

  • Pharmacy
  • Wautoma, WI
  • NPI 1174322846
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013036433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S TOWNLINE ROAD",
            "address_2": "BOX 1440",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "54982",
            "telephone_number": "920-787-5514",
            "fax_number": "920-787-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S TOWNLINE ROAD",
            "address_2": "BOX 1440",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "54982",
            "telephone_number": "920-787-5514",
            "fax_number": "920-787-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5318015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33765400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Lee Behnke, APSW, SAC-IT
• Robert K Bennot
• Terri L Billington, SAC-IT
• Bobbie J Bleskey, LPC, CSAC, ICS
• Dino J Bordini, D.D.S.
• Kaitlyn Bruening, RDH
• Kathleen Busse, RDH
• Joseph W Caron, MD
• Cedar Pines Inc.
• Cedar Pines, Inc

• General Practice Dentistry in Wautoma, WI
• Providers in Wautoma, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.