Alexander Young Brown III, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015792 Issued in GA

Practice address

1130 Brampton Ave
Statesboro, GA 30458-0847

Phone

(912) 764-3724

NPI assigned

Jan 8, 2019

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Premier Dental Wellness LLC

  • General Practice Dentistry
  • Statesboro, GA
  • NPI 1740038074
  NPD (past)

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1629541016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 HILLWOOD DR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304589114",
            "telephone_number": "912-682-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580847",
            "telephone_number": "912-764-3724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ALEXANDER",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian a Moogerfeld MD, LLC
• Caenadi Bright
• Brighter Brains, LLC
• Keaundria Shaquille Broomfield, MT
• Tamaya Browder
• Corinne M Brown, BCBA
• Daphne Brown
• Jarrod H. Brown, DDS
• Jennifer Lane Brown, MS, ATC, LAT
• Natalie Brown, LAT, ATC

• General Practice Dentistry in Statesboro, GA
• Providers in Statesboro, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.