Provider Demographics
NPI:1083753107
Name:BROWN, ROBERT JULIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JULIAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 EL CERRO BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1731
Mailing Address - Country:US
Mailing Address - Phone:925-837-8048
Mailing Address - Fax:925-837-8049
Practice Address - Street 1:400 EL CERRO BLVD STE 105
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-1731
Practice Address - Country:US
Practice Address - Phone:925-837-8048
Practice Address - Fax:925-837-8049
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
CA17881122300000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA17881OtherDDS LICENSE
CA1083753107OtherNPI FOR DR. ROBERT BROWN