Jacklyn Michele Brown, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30.025979 Issued in OH

Practice address

1304 Liberty PL
Sicklerville, NJ 08081

Phone

(856) 875-9550

NPI assigned

Mar 9, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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 and National Provider Directory roles.

• Flanders Pediatric Dentistry & Orthodontics LLC

  • Pediatric Dentistry
  • Flanders, NJ
  • NPI 1699616839
  NPD (past)

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

{
    "created_epoch": "1362787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1750622155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4086 BORGE WAY",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430167377",
            "telephone_number": "516-589-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 LIBERTY PL",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "08081",
            "telephone_number": "856-875-9550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 Briggs Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Laurel",
            "state": "NJ",
            "postal_code": "080544630",
            "country_code": "US",
            "telephone_number": "856-875-9550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 Route 322",
            "address_purpose": "LOCATION",
            "city": "Woolwich Township",
            "state": "NJ",
            "postal_code": "080853701",
            "country_code": "US",
            "telephone_number": "856-875-9550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 US Highway 206 Ste 305",
            "address_purpose": "LOCATION",
            "city": "Flanders",
            "state": "NJ",
            "postal_code": "078369190",
            "country_code": "US",
            "telephone_number": "973-927-2260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACKLYN",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-09",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401415136",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.025979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy Marie Brocco, MSW,LCSW,CBT,BCD
• Felecia L Brodie, LCSW
• Alise Bronson, LMSW
• Daniel Anthony Brookbank, PHARMD
• Kia Brooks
• Samatha Brown
• Seanna Brown
• Shaquana Brown
• Tiffany Brown
• Wendi Ann Brown, RPH

• Pediatric Dentistry in Sicklerville, NJ
• Providers in Sicklerville, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.