Provider Demographics
NPI:1114347861
Name:BROWN, ZACHARY L (DDS, MD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 BELLEVIEW AVE STE L10
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1360
Mailing Address - Country:US
Mailing Address - Phone:816-561-1115
Mailing Address - Fax:
Practice Address - Street 1:4700 BELLEVIEW AVE STE L10
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1360
Practice Address - Country:US
Practice Address - Phone:573-353-8549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS615461223S0112X
MO20190066641223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery