Individual provider Active NPI

Ronald Stephen Brown

  • Oral and Maxillofacial Pathology Dentistry
  • Washington, DC
National Provider Identifier
1891908661
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
2923 Issued in DC
Practice address
4400 Jenifer St NW Ste 270
Washington, DC 20015-2113
Phone
(202) 964-9400
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 2923 DC Primary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 4170 VA
Oral and Maxillofacial Pathology Dentistry 1223P0106X 5621 MD

Addresses

Primary practice location

4400 Jenifer St NW Ste 270
Washington, DC 20015-2113

Mailing address

2206 N Nelson St
Arlington, VA 22207-3841
Phone (703) 528-2816

Other identifiers 1

IdentifierTypeStateIssuer
11689844OtherDCCAQH PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20040513000948 DC Practitioner - DentistPractitioner - Oral Surgery 7214927144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4400 Jenifer St NW
Suite 270
Washington, DC 20015-2113
Phone (240) 444-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2923DCMDOral and Maxillofacial Pathology Dentist
5621MDMDOral and Maxillofacial Pathology Dentist
4170VAMDOral and Maxillofacial Pathology Dentist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891908661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 N NELSON ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222073841",
            "telephone_number": "703-528-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 JENIFER ST NW STE 270",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152113",
            "telephone_number": "202-964-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RONALD",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "DC",
            "license": "2923",
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "VA",
            "license": "4170",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MD",
            "license": "5621",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER NUMBER",
            "identifier": "11689844",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.