Individual provider Active NPI

Luke Brown, DMD

  • Dentist
  • Saint Louis, MO
National Provider Identifier
1336872985
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2022023449 Issued in MO
Practice address
5647 Delmar Blvd
Saint Louis, MO 63112-2615
Phone
(314) 367-7848
NPI assigned
Jul 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2022023449 MO Primary

Addresses

Primary practice location

5647 Delmar Blvd
Saint Louis, MO 63112-2615

Mailing address

5701 Delmar Blvd
Saint Louis, MO 63112-2617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240226000622 MO Practitioner - Dentist 0648615047 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Betty Jean Kerr People'S Health Centers CurrentSince Mar 11, 2024 Accepting new patients
Betty Jean Kerr People'S Health Centers CurrentSince Mar 11, 2024 Accepting new patients
Acton Dental, LLC PastSince Jul 1, 2022 Accepting new patients

Locations

5647 Delmar Blvd
Saint Louis, MO 63112
Phone (314) 678-4450

5701 Delmar Blvd
Saint Louis, MO 63112
Phone 31436778481248

Interoperability endpoints

  • Direct secure messaging: luke.brown.p1@direct.phcenters.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1336872985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631122617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5647 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631122615",
            "telephone_number": "314-367-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LUKE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-01",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2022023449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.