Jacob Samuel Brown, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

26302 Issued in TX

Practice address

4805 Green Oaks Dr
River Oaks, TX 76114-3004

Phone

(817) 625-1548

NPI assigned

Jul 1, 2011

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1730476466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 GREEN OAKS DR",
            "city": "RIVER OAKS",
            "state": "TX",
            "postal_code": "761143004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 GREEN OAKS DR",
            "city": "RIVER OAKS",
            "state": "TX",
            "postal_code": "761143004",
            "telephone_number": "817-625-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACOB",
        "middle_name": "SAMUEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "26302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Better Bodies Chiropractic & Healthcenter
• Kylie E Blackwell
• Gracie Blyleven, RBT
• Alyssa K Brashier
• Christy Brinkley
• Jessica Brown, RBT
• Kent Robert Brown, D.D.S.
• Ashley Buckhalter, RBT
• Yvonne Bui, RBT
• Karson Calverley

• General Practice Dentistry in River Oaks, TX
• Providers in River Oaks, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.