Active NPI
Mark J Brown, D.D.S.
- Dentist
- Nevada City, CA
National Provider Identifier
1750519765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 58387
- Practice address
- 707 Zion St
Suite C
Nevada City, CA 95959-2932 - Phone
- (530) 265-4206
- Fax
- (530) 265-9033
- NPI assigned
- Jun 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 58387 | CA | Primary |
Addresses
Primary practice location
707 Zion St
Suite C
Nevada City, CA 95959-2932
Mailing address
13101 Peninsula Dr
Auburn, CA 95602-8950
Phone (530) 559-7211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151013000043 | CA | Order and Referring Only - Dentist | 3173832227 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jasper Yai, DDS, Inc. | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490313600000",
"number": "1750519765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13101 PENINSULA DR",
"city": "AUBURN",
"state": "CA",
"postal_code": "956028950",
"telephone_number": "530-559-7211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 ZION ST",
"address_2": "SUITE C",
"city": "NEVADA CITY",
"state": "CA",
"postal_code": "959592932",
"telephone_number": "530-265-4206",
"fax_number": "530-265-9033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "MARK",
"middle_name": "J",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-29",
"last_updated": "2017-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "58387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nevada City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.