Kimberly Brown, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN014931 Issued in GA

Practice address

395 N Jeff Davis Dr Ste a
Fayetteville, GA 30214-1672

Phone

(770) 460-0870

NPI assigned

Jun 15, 2006

Last updated

Jun 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smith, Spelios and Associates LLC

  • Point of Service
  • Fayetteville, GA
  • NPI 1821149469
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1720022304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HAMMOCK BAY DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302157152",
            "telephone_number": "601-572-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 N JEFF DAVIS DR STE A",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141672",
            "telephone_number": "770-460-0870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3502 W Northside Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392134454",
            "country_code": "US",
            "telephone_number": "601-362-5321",
            "fax_number": "601-364-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3174",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660404",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destinee Brown, RBT
• Frank Brown, MD
• George Thomas Brown III, DMD
• India Brown, OTR/L
• Kelley Brown, MA, LAPC
• Pandora G Brown, CERTIFIED HAIR LOSS
• Thomas Matthew Brown, O.D.
• Jessica Brownfield, PT, DPT
• Phillip Earl Brownlee, DDS
• Brubaker Physical Therapy, LLC

• General Practice Dentistry in Fayetteville, GA
• Providers in Fayetteville, 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 Jun 16, 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.