Pierce Brown

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001354-15 Issued in WI

Practice address

545 E Johnson St
Fond Du Lac, WI 54935-2856

Phone

(920) 924-9090

NPI assigned

Jun 22, 2016

Sex

Male

Sole proprietor

Yes

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 WI

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

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.

• Dental Associates LTD of Wisconsin

  • Endodontics
  • Wauwatosa, WI
  • NPI 1518266998

  General Practice

  NPD (past)
• Dental Assosiates

  • Dental Clinic/Center
  • Fond Du Lac, WI
  • NPI 1558710269
  NPD (past)

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1831540764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 VAN DYNE RD",
            "address_2": "203",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549371817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 E JOHNSON ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549352856",
            "telephone_number": "920-924-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "PIERCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001354-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eddie Kiyoshi Brotkowski, D.D.S., M.D.
• Joline Brotzman, MS, RN, PMHCNS-BC
• Lisa Diane Brown, LCSW
• Lisette C Brown, PA C
• Pamela G Brown, OD
• Rachel A Brown
• Tristan G Brown, OD
• Kimberly Jean Bruening
• Mark Allen Bruhn, DDS
• Kelly Jean Brunet, NP

• General Practice Dentistry in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.