Jacob Brown, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

D10869 Issued in OR

Practice address

142 SW 2ND St
Corvallis, OR 97333-4716

Phone

(541) 360-7004

NPI assigned

Jul 26, 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

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1609353168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 SW 2ND ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334716",
            "telephone_number": "541-360-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 SW 2ND ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334716",
            "telephone_number": "541-360-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenna Brown, SLP
• Charlene Nichole Brown
• Connor Alan Brown
• Elizabeth Anne Brown, ANP
• Emi Sumida Brown
• Jasmine Brown
• Jason Scott Brown
• Jennifer Brown, D.O.
• Kathryn A Brown, MSW, LCSW
• Katy Jane Brown, D.O.

• Dentist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.