Individual provider Active NPI

Thomas A. Brown, D.D.S.

  • Dentist
  • Traverse City, MI
National Provider Identifier
1457732877
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901601260 Issued in MI
Practice address
1208 E Eighth St
Traverse City, MI 49686-2939
Phone
(574) 527-8399
NPI assigned
Jun 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12012344A IN
Dentist 122300000X DEN.00204227 CO
Dentist 122300000X 2901601260 MI Primary

Addresses

Primary practice location

1208 E Eighth St
Traverse City, MI 49686-2939

Mailing address

601 Riverine Dr Apt 204
Traverse City, MI 49684-3200
Phone (574) 527-8399

Other practice location 1

2902 Evergreen Pkwy
Evergreen, CO 80439-7922
Phone (720) 924-4859

Other practice location 2

935 N Detroit St
Warsaw, IN 46580-2914
Phone (574) 267-3359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00204227COMDDentist
12012344AINMDDentist
2901601260MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas a. Brown DDS, PLLC CurrentSince Feb 12, 2023 Accepting new patients

Locations

1208 E Eighth St
Traverse City, MI 49686
Phone (231) 946-6561

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.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1457732877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 RIVERINE DR APT 204",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843200",
            "telephone_number": "574-527-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 E EIGHTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862939",
            "telephone_number": "574-527-8399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2902 Evergreen Pkwy",
            "address_purpose": "LOCATION",
            "city": "Evergreen",
            "state": "CO",
            "postal_code": "804397922",
            "country_code": "US",
            "telephone_number": "720-924-4859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "935 N Detroit St",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465802914",
            "country_code": "US",
            "telephone_number": "574-267-3359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "THOMAS",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012344A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00204227",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.