Justin Brown DDS LLC

Primary specialty

DentistTaxonomy code 122300000X

License

10988 Issued in IN

Legal business name

JUSTIN BROWN DDS LLC

Doing business as

Peru Dental Care

Practice address

5 Logan St
Peru, IN 46970-1642

Phone

(765) 473-9336

Fax

(765) 460-5743

NPI assigned

Dec 4, 2007

Last updated

Jul 26, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin D Brown, DDSNPI 1013110568

Title

Owner

Phone

(765) 473-9336

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Peru Dental Care Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin David Brown, D.D.S.

  • General Practice Dentistry
  • Peru, IN
  • NPI 1013110568
  NPD (past) Authorized official
• Thomas J Guthrie, DDS

  • General Practice Dentistry
  • Peru, IN
  • NPI 1710082409
  NPD (past)

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1851573539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LOGAN ST",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469701642",
            "telephone_number": "765-473-9336",
            "fax_number": "765-460-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 LOGAN ST",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469701642",
            "telephone_number": "765-473-9336",
            "fax_number": "765-460-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN BROWN DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-473-9336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "10988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200864790A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peru Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanisha Johnson, LPN
• Aaron Michael Jones, D.C.
• Amanda Lynn Jones, D.C.
• Michael Lee Jones, M.D.
• Trent R Jones, D.C.
• Kairos Clinic
• Eamonn M Keane, MD
• Richard L Keller II, MD
• Stephen D Kennedy, MD
• Agnes Kenny, MD

• Dentist in Peru, IN
• Providers in Peru, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.