Provider Demographics
NPI:1336264027
Name:BROWN, JAMES D (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
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 1:135 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1539
Mailing Address - Country:US
Mailing Address - Phone:317-873-4609
Mailing Address - Fax:317-873-4609
Practice Address - Street 1:135 S 2ND ST
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1539
Practice Address - Country:US
Practice Address - Phone:317-873-4609
Practice Address - Fax:317-873-4609
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120070941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice