Edward De Witt Brown Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1901 Issued in LA

Practice address

600 Cline St.
Minden, LA 71055

Phone

(318) 377-0763

Fax

(318) 377-0764

NPI assigned

Jul 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Sr Minden LLC

  dba Southern Roots Dentistry

  • Dentist
  • Minden, LA
  • NPI 1902475072
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255355418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1056",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710581056",
            "telephone_number": "318-377-0763",
            "fax_number": "318-377-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CLINE ST.",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "71055",
            "telephone_number": "318-377-0763",
            "fax_number": "318-377-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "EDWARD",
        "middle_name": "DE WITT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "1901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09831",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Paige Breard, PHARMD
• Brighter Future Counseling Services, LLC
• Brighter Tomorrows, Inc.
• Lakeshia Brooks
• Alice Brown
• Hodson Brown, DPT
• Lekidra M Brown, NP
• Rebecca P Brown, FNP
• Robert Ray Brown, FNP-C
• Brownstone, LLC (Best Kare Journey)

• General Practice Dentistry in Minden, LA
• Providers in Minden, LA by specialty
• General Practice Dentistry in Louisiana

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.