Slater Lynn Brown

Primary specialty

DentistTaxonomy code 122300000X

License

40715 Issued in TX

Practice address

1100 Wilford Hall Loop
Jbsa - Wilford Hall Ambulatory Surgical Center
San Antonio, TX 78236

Phone

(210) 292-7412

NPI assigned

Mar 30, 2023

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

Medicare fee-for-service enrollment

Enrolled in TX

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

State licenses

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1780389882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "address_2": "JBSA - WILFORD HALL AMBULATORY SURGICAL CENTER",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-292-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "address_2": "JBSA - WILFORD HALL AMBULATORY SURGICAL CENTER",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-292-7412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "972-841-5846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SLATER",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-30",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "40715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sadie Brown, PA
• Samantha Brown
• Sarah Michelle Brown
• Seth Alan Brown
• Shanika Nicole Brown
• Sophia Brown
• Spencer Brown
• Suzanne Jill Witken Brown, RN, NBC-HWC
• Tamara Brown, RN
• Tamika N Brown

• Dentist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.