Brockton Brown, DMD

Individual provider Active NPI General Practice Dentistry · West Plains, MO

NPI 1982394730 · NPPES record last updated Aug 4, 2025

Key facts

NPI
1982394730
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2025027793 (MO)
Practice address
3000 Independence SQ
West Plains, MO 65775-4239
Phone
(870) 917-4148
NPI assigned
May 15, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2025027793MOMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2025027793 MO Yes

Addresses

Primary practice location

3000 Independence SQ
West Plains, MO 65775-4239

Mailing address

22 Dogwood Cir
West Plains, MO 65775-5171

Other providers in West Plains, MO

All providers in West Plains, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.