Individual provider Active NPI

Desmon Antonio Brown Jr., DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Indianapolis, IN
National Provider Identifier
1457554412
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12011641A Issued in IN
Practice address
1001 W. 10TH Street
#3101
Indianapolis, IN 46202-2859
Phone
(317) 630-6297
Fax
(317) 630-2424
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X DRP560 FL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 12011641A IN Primary

Addresses

Primary practice location

1001 W. 10TH Street
#3101
Indianapolis, IN 46202-2859

Mailing address

1168 Westvalie Drive
Carmel, IN 46032
Phone (904) 537-5764

Other practice location 1

550 University Blvd Ste 3195
Indianapolis, IN 46202-5149
Phone (317) 274-7433

Other practice location 2

1121 W Michigan St
Indianapolis, IN 46202-5211
Phone (317) 274-7433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110802000151 IN Practitioner - Maxillofacial SurgeryPractitioner - AnesthesiologyPractitioner - Oral SurgeryPractitioner - Dentist 5294904652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Anesthesiology, Dentist, Oral Surgery
Education
Howard University College of Dentistry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana UniversityGroup PAC ID 6002806957, 64 clinicians

Practice addresses (Care Compare)

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 274-8300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12011641AINMDOral and Maxillofacial Surgery (Dentist)
DRP560FLMDOral & Maxillofacial Surgery (D.M.D.)

Interoperability endpoints

  • Direct secure messaging: dbrown14816@direct.eskenazihealth.edu

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1457554412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1168 WESTVALIE DRIVE",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "46032",
            "telephone_number": "904-537-5764",
            "fax_number": "317-274-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W. 10TH STREET",
            "address_2": "#3101",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022859",
            "telephone_number": "317-630-6297",
            "fax_number": "317-630-2424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 University Blvd Ste 3195",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-274-7433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1121 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025211",
            "country_code": "US",
            "telephone_number": "317-274-7433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DESMON",
        "middle_name": "ANTONIO",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "DRP560",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12011641A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.