Individual provider Active NPI

William Brownscombe

  • Dentist
  • Saint Clair Shores, MI
National Provider Identifier
1760512339
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13473 Issued in MI
Practice address
24055 Jefferson Ave
Suite 210
Saint Clair Shores, MI 48080-1511
Phone
(586) 773-1050
Fax
(586) 773-2059
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13473 MI Primary

Addresses

Primary practice location

24055 Jefferson Ave
Suite 210
Saint Clair Shores, MI 48080-1511

Mailing address

24055 Jefferson Ave
Suite 210
Saint Clair Shores, MI 48080-1511
Phone (586) 773-1050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13473MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760512339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24055 JEFFERSON AVE",
            "address_2": "SUITE 210",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801511",
            "telephone_number": "586-773-1050",
            "fax_number": "586-773-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24055 JEFFERSON AVE",
            "address_2": "SUITE 210",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801511",
            "telephone_number": "586-773-1050",
            "fax_number": "586-773-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWNSCOMBE",
        "first_name": "WILLIAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "13473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.