Provider Demographics
NPI:1578634861
Name:BROWN, STEPHEN C (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
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 1:14494 STONE HORSE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-1514
Mailing Address - Country:US
Mailing Address - Phone:804-752-7452
Mailing Address - Fax:804-752-2048
Practice Address - Street 1:6901 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3647
Practice Address - Country:US
Practice Address - Phone:804-288-5324
Practice Address - Fax:804-285-4098
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA52811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA107790OtherANTHEM PROVIDER NUMBER