Individual provider Active NPI

Jay Michael Brown, DMD

  • Dentist
  • Joplin, MO
National Provider Identifier
1427587567
Registry record updated Jun 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2017018303 Issued in MO
Practice address
530 S Maiden LN
Joplin, MO 64801-3084
Phone
(417) 782-6200
Fax
(417) 782-6200
NPI assigned
Jun 11, 2017
Last updated
Jun 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2017018303 MO Primary

Addresses

Primary practice location

530 S Maiden LN
Joplin, MO 64801-3084

Mailing address

530 S Maiden LN
Joplin, MO 64801-3084
Phone (417) 782-6200

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
I20170802000417 MO Order and Referring Only - DentistPractitioner - Dentist 7719258227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017018303MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
JMB Dental, LLC Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1497139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497139200000",
    "number": "1427587567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S MAIDEN LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648013084",
            "telephone_number": "417-782-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S MAIDEN LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648013084",
            "telephone_number": "417-782-6200",
            "fax_number": "417-782-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JAY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-11",
        "last_updated": "2017-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2017018303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.