NPIMap

Organization Active NPI

Tanner Brown DMD LLC

  • Dental Clinic/Center
  • Saint Peters, MO
National Provider Identifier
1649049248
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
TANNER BROWN DMD LLC
Practice address
6065 Mid Rivers Mall Dr
Saint Peters, MO 63304-1108
Phone
(636) 928-4090
NPI assigned
Dec 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Authorized official

Name
Dr. Tanner Michael Brown, DMDNPI 1588222632
Title
Dentist
Phone
(618) 791-7666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

6065 Mid Rivers Mall Dr
Saint Peters, MO 63304-1108

Mailing address

6065 Mid Rivers Mall Dr
Saint Peters, MO 63304-1108
Phone (618) 791-7666

Other practice location 1

475 Miralago Shore Dr
Saint Peters, MO 63376-3189
Phone (636) 928-4090

National Provider Directory

National Provider Directory
Tax ID family
Tanner Brown DMD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1703203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1649049248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6065 MID RIVERS MALL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633041108",
            "telephone_number": "618-791-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6065 MID RIVERS MALL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633041108",
            "telephone_number": "636-928-4090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Miralago Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633763189",
            "country_code": "US",
            "telephone_number": "636-928-4090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TANNER BROWN DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-22",
        "last_updated": "2023-12-22",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TANNER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "618-791-7666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.