Brandon Wayne Cousins, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2018016943 Issued in MO

Practice address

485 Wildwood Pkwy Ste 5
Ballwin, MO 63011-2667

Phone

(636) 227-8400

NPI assigned

May 29, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Amanda J. Darling, D.D.S., P.C.

  • General Practice Dentistry
  • Ballwin, MO
  • NPI 1588830483
  NPD (past)
• Missouri Dental Professionals, Richard Straus, DMD, PC

  • General Practice Dentistry
  • Chesterfield, MO
  • NPI 1285057521
  NPD (past)

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1417448259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 WILDWOOD PKWY STE 5",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112667",
            "telephone_number": "636-227-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 WILDWOOD PKWY STE 5",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112667",
            "telephone_number": "636-227-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSINS",
        "first_name": "BRANDON",
        "middle_name": "WAYNE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2018016943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret M Connelly
• Evan Coonrod
• Cordray Counseling, LLC
• John Paul Cordray, LPC
• Mario Everardo Coronado, RPH
• Jeffrey Cowdry
• Gregory Kenneth Cox
• Crescent Bioscientific Labatory Inc
• Crescent Home Health Care LLC
• Ann Elizabeth Cribbin

• General Practice Dentistry in Ballwin, MO
• Providers in Ballwin, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.