Provider Demographics
NPI:1205934163
Name:BROWN AND SUTT, PLLC
Entity type:Organization
Organization Name:BROWN AND SUTT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ADWOA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BAIDOO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:540-434-2102
Mailing Address - Street 1:2015 RESERVOIR ST STE C, STEPHEN J BROWN DDS, PLLC
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8739
Mailing Address - Country:US
Mailing Address - Phone:540-434-2102
Mailing Address - Fax:540-434-0300
Practice Address - Street 1:2015 RESERVOIR ST STE C
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8739
Practice Address - Country:US
Practice Address - Phone:540-434-2102
Practice Address - Fax:540-434-0300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010062151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA690902OtherUNITED CONCORDIA
VA463231OtherANTHEM
VA463230OtherANTHEM