Active NPI
Shanan Marie Brown, D.D.S.
- Pediatric Dentistry
- Corpus Christi, TX
National Provider Identifier
1700083292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 23376
- Practice address
- 6200 Saratoga Blvd
Corpus Christi, TX 78414-3421 - Phone
- (210) 859-6261
- NPI assigned
- Jun 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 23376 | TX | Primary |
Addresses
Primary practice location
6200 Saratoga Blvd
Corpus Christi, TX 78414-3421
Mailing address
6200 Saratoga Blvd
Corpus Christi, TX 78414-3421
Phone (210) 859-6261
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700083292 | Medicaid | TX |
Other names 1
- Shanan Marie Mossman
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23376 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718150400000",
"number": "1700083292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6200 SARATOGA BLVD",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784143421",
"telephone_number": "210-859-6261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6200 SARATOGA BLVD",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784143421",
"telephone_number": "210-859-6261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SHANAN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-28",
"last_updated": "2024-06-12",
"certification_date": "2024-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "23376",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700083292",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHANAN",
"last_name": "MOSSMAN",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.