Individual provider Active NPI

Kimberly Diane Brown, D.D.S.

  • Dentist
  • Baton Rouge, LA
National Provider Identifier
1497038780
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6222 Issued in LA
Practice address
5151 Plank
Baton Rouge, LA 70805-3501
Phone
(225) 330-6622
Fax
(225) 356-8163
NPI assigned
Sep 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6222 LA Primary

Addresses

Primary practice location

5151 Plank
Baton Rouge, LA 70805-3501

Mailing address

5151 Plank
Baton Rouge, LA 70805-3501
Phone (225) 330-6622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20171025001849 LA Order and Referring Only - DentistPractitioner - Dentist 7618243346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6222LAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1497038780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 PLANK",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708053501",
            "telephone_number": "225-330-6622",
            "fax_number": "225-356-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 PLANK",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708053501",
            "telephone_number": "225-330-6622",
            "fax_number": "225-356-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KIMBERLY",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "6222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.