Richard Wallace Brown, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D10227 Issued in MN

Practice address

123 3Rd St
Balaton, MN 56115

Phone

(507) 734-2251

Fax

(507) 734-2077

NPI assigned

Nov 27, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

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.

• Balaton Dental Clinic,Inc

  • General Practice Dentistry
  • Balaton, MN
  • NPI 1982031878
  NPD (past) Authorized official

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1750457396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "address_2": "123 3RD ST",
            "city": "BALATON",
            "state": "MN",
            "postal_code": "56115",
            "telephone_number": "507-734-2251",
            "fax_number": "507-734-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 3RD ST",
            "city": "BALATON",
            "state": "MN",
            "postal_code": "56115",
            "telephone_number": "507-734-2251",
            "fax_number": "507-734-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RICHARD",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN TAX ID",
            "identifier": "7996351",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Balaton Dental Clinic,Inc
• Balaton Public School
• City of Balaton (Balaton Ambulance)
• Kathryn Determan, DDS
• Jenna Elizabeth Erickson, CNM. IBCLC
• Lsi Services, LLC (Colonial Manor of Balaton)
• Amy Perlenfein

• Dentist in Balaton, MN
• Providers in Balaton, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.