Provider Demographics
NPI:1871913608
Name:BROWN, AKEYLA BRIANA (DDS)
Entity type:Individual
Prefix:DR
First Name:AKEYLA
Middle Name:BRIANA
Last Name:BROWN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 BREWERS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2017
Mailing Address - Country:US
Mailing Address - Phone:732-942-6900
Mailing Address - Fax:732-942-7045
Practice Address - Street 1:688 BREWERS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527
Practice Address - Country:US
Practice Address - Phone:732-942-6900
Practice Address - Fax:732-942-7045
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-19
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC390200000X
NJ22DI027121001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program