Charlene Brown

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015100 Issued in GA

Practice address

4060 Peachtree Rd NE Ste H
Brookhaven, GA 30319-3020

Phone

(404) 549-2650

NPI assigned

Mar 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Brookhaven Dental Group LLC

  • General Practice Dentistry
  • Brookhaven, GA
  • NPI 1295602282
  NPD

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1104219492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 PEACHTREE RD NE STE H",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193020",
            "telephone_number": "404-594-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 PEACHTREE RD NE STE H",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193020",
            "telephone_number": "404-549-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CHARLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-10",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015100",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6590",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookleigh Family Eyecare, Inc
• Ashley Armbruster Brooks, OT
• Keisha Renee Brooks
• Lapachus Tacorra-Samone Brooks, BS
• Shelby Broughton, ATC, OTC
• Cinnamon Brown
• Elizabeth Brown
• Kiana Brown, RBT
• M. D. Brown, PH.D, LPC, NCC, CPSC
• Henry Thien Bui, BS

• General Practice Dentistry in Brookhaven, GA
• Providers in Brookhaven, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; 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.