Dr. Jack I. Brown, DDS, Inc

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

18295 Issued in CA

Legal business name

DR. JACK I. BROWN, DDS, INC

Practice address

416 N Bedford Dr
Suite 103
Beverly Hills, CA 90210-4322

Phone

(310) 278-9624

Fax

(310) 278-0695

NPI assigned

Aug 13, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tammy R. Alsobrook, RDA

Title

Office Manager

Phone

(310) 278-9624

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033121405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 N BEDFORD DR",
            "address_2": "SUITE 103",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104322",
            "telephone_number": "310-278-9624",
            "fax_number": "310-278-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N BEDFORD DR",
            "address_2": "SUITE 103",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104322",
            "telephone_number": "310-278-9624",
            "fax_number": "310-278-0695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JACK I. BROWN, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALSOBROOK",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "310-278-9624",
        "authorized_official_credential": "RDA"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "18295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.