Individual provider Active NPI

Mark J Brown, D.D.S.

  • Dentist
  • Nevada City, CA
National Provider Identifier
1750519765
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
58387 Issued in CA
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

Updated by the provider on Mar 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151013000043 CA Order and Referring Only - DentistPractitioner - Dentist 3173832227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jasper Yai, DDS, Inc. Dentist PastSince Jul 31, 2023 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

Verify at the official NPI Registry.