Charles Martin Brown, DDS, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

15019 Issued in TX

Practice address

4010 Vista Rd Ste C
Pasadena, TX 77504-2140

Phone

(713) 944-1320

Fax

(713) 944-2158

NPI assigned

Aug 12, 2006

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 23, 2015 through Dec 23, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669484689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 VISTA RD STE C",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775042140",
            "telephone_number": "713-944-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 VISTA RD STE C",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775042140",
            "telephone_number": "713-944-1320",
            "fax_number": "713-944-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CHARLES",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "15019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard G Brassard, D.C.
• Karlie Trosclair Breaux, PA-C
• Lori Briscoe
• Lisa Michele Brockman, RPH
• Annette Marie Brown, DO
• Emily Erin Brown, R.D.
• Evelyn Brown
• Kristen K Brumley
• Robin Brunnemann, M.D.
• Kathlyn Langham Bryant, M.ED., L.P.C.

• Periodontics in Pasadena, TX
• Providers in Pasadena, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.