Active NPI
Michael Joel Brown, D.D.S.
- General Practice Dentistry
- Holmen, WI
National Provider Identifier
1396005237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6981-15
- Practice address
- 106 S Holmen Dr
Holmen, WI 54636-9467 - Phone
- (608) 526-9243
- Fax
- (608) 526-1099
- NPI assigned
- May 25, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6981-15 | WI | Primary |
Addresses
Primary practice location
106 S Holmen Dr
Holmen, WI 54636-9467
Mailing address
508 Woodard Ave
Tomah, WI 54660-2051
Phone (414) 587-2485
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161028000369 | WI | Order and Referring Only - Oral Surgery | 9234417171 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6981-15 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458691200000",
"number": "1396005237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 WOODARD AVE",
"city": "TOMAH",
"state": "WI",
"postal_code": "546602051",
"telephone_number": "414-587-2485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 S HOLMEN DR",
"city": "HOLMEN",
"state": "WI",
"postal_code": "546369467",
"telephone_number": "608-526-9243",
"fax_number": "608-526-1099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "MICHAEL",
"middle_name": "JOEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-25",
"last_updated": "2016-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "6981-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holmen, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.