Active NPI
Michele Lee Brown, DMD
- Dentist
- Saint Louis, MO
National Provider Identifier
1174196422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2022018454
- Practice address
- 7265 Watson Rd
Saint Louis, MO 63119-4401 - Phone
- (314) 352-3886
- NPI assigned
- Jul 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.033173 | IL | |
| Dentist | 122300000X | 2022018454 | MO | Primary |
Addresses
Primary practice location
7265 Watson Rd
Saint Louis, MO 63119-4401
Mailing address
1739 Knoll Ter
Saint Peters, MO 63376-7563
Phone (618) 402-2778
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.033173 | IL | MD | Dentist |
| 2022018454 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1174196422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1739 KNOLL TER",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633767563",
"telephone_number": "618-402-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7265 WATSON RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631194401",
"telephone_number": "314-352-3886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "MICHELE",
"middle_name": "LEE",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-22",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "IL",
"license": "019.033173",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2022018454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.