David Thomas Brown, DDS

Individual provider Active NPI General Practice Dentistry · Kalamazoo, MI

NPI 1376547208 · NPPES record last updated Jan 31, 2016

Key facts

NPI
1376547208
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2901012181 (MI)
Practice address
2134 E G Ave
Kalamazoo, MI 49004-1751
Phone
(269) 349-4231
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160208000016 MI Order and Referring Only - Dentist
Practitioner - Dentist
2062716350

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2901012181MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
David T Brown DDS PC Past
since Feb 23, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901012181 MI Yes

Addresses

Primary practice location

2134 E G Ave
Kalamazoo, MI 49004-1751

Mailing address

2134 E G Ave
Kalamazoo, MI 49004-1751
Phone (269) 349-4231

Other identifiers

IdentifierTypeStateIssuer
1696733 12MedicaidMI

Other providers in Kalamazoo, MI

All providers in Kalamazoo, MI · General Practice Dentistry in Michigan

Sources for this page

Verify at the official NPI Registry.