Provider Demographics
NPI:1740578798
Name:JEFFREY BROWN DMD, PLLC
Entity Type:Organization
Organization Name:JEFFREY BROWN DMD, PLLC
Other - Org Name:JEFFREY BROWN DMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-806-6073
Mailing Address - Street 1:2353 ALEXANDRIA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3264
Mailing Address - Country:US
Mailing Address - Phone:859-494-1042
Mailing Address - Fax:
Practice Address - Street 1:2353 ALEXANDRIA DR
Practice Address - Street 2:SUITE 300
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3264
Practice Address - Country:US
Practice Address - Phone:859-494-1042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9039261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental