Individual provider Active NPI

Austin Nicholas Brown, DDS

  • General Practice Dentistry
  • St Simons Island, GA
National Provider Identifier
1699408948
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN122753 Issued in GA
Practice address
288 Redfern VLG
St Simons Island, GA 31522-2536
Phone
(912) 638-9090
NPI assigned
Jul 5, 2022
Last updated
Jul 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN122753 GA Primary

Addresses

Primary practice location

288 Redfern VLG
St Simons Island, GA 31522-2536

Mailing address

110 Chinquapin Dr
Brunswick, GA 31523-7059
Phone (770) 295-8384

Other practice location 1

4741 Altama Ave
Brunswick, GA 31520-2910
Phone (912) 262-1081

Other practice location 2

618 E Carter Ave
Blackshear, GA 31516-1559
Phone (912) 449-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN122753GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
South Port Dentistry CurrentSince Jan 21, 2024 Accepting new patients
Coastal Kids Dentistry CurrentSince Jan 21, 2024 Accepting new patients
Brunswick Dentisty LLC General Practice Past Accepting new patients
Blackshear Family Dentistry LLC PastSince May 4, 2025 Accepting new patients

Locations

288 Redfern Vlg
St Simons Island, GA 31522
Phone (912) 638-9090

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1699408948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CHINQUAPIN DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315237059",
            "telephone_number": "770-295-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 REDFERN VLG",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222536",
            "telephone_number": "912-638-9090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4741 Altama Ave",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315202910",
            "country_code": "US",
            "telephone_number": "912-262-1081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 E Carter Ave",
            "address_purpose": "LOCATION",
            "city": "Blackshear",
            "state": "GA",
            "postal_code": "315161559",
            "country_code": "US",
            "telephone_number": "912-449-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "AUSTIN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Simons Island, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.