Provider Demographics
NPI:1447470406
Name:BROWN, JEFFREY NOEL (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:NOEL
Last Name:BROWN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 WORNALL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-1344
Mailing Address - Country:US
Mailing Address - Phone:816-363-9993
Mailing Address - Fax:816-363-0935
Practice Address - Street 1:7110 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1344
Practice Address - Country:US
Practice Address - Phone:816-363-9993
Practice Address - Fax:816-363-0935
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001625971223G0001X
KS601091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice