Mitchell York Brown, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13994064-9923 Issued in UT

Practice address

Building 25501 Brainard Ave
Fort Eisenhower, GA 30905

Phone

(706) 787-7050

NPI assigned

May 28, 2024

Last updated

Dec 19, 2024By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1104666221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 S CARMEL RIDGE CIR",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847201995",
            "telephone_number": "435-592-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING 25501 BRAINARD AVE",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "30905",
            "telephone_number": "706-787-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MITCHELL",
        "middle_name": "YORK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "13994064-9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Donald Beres, M.D.
• Spencer Blankenship, OTD
• David Edward Bonnin, MD
• Benjamin Brainerd
• Kerrianne Bresnan, PSY.D.
• Leslee Nichole Browning, PSY.D.
• Lauren Geeter Bursey, NP
• John Price Caldwell Sr., M.D.
• Christina Janelle Campo Ford, PA-C
• Jane Emily Carnett, RDN

• General Practice Dentistry in Fort Eisenhower, GA
• Providers in Fort Eisenhower, 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 Dec 19, 2024; 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.