Provider Demographics
NPI:1861383200
Name:BROWN, JARED DANIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:DANIEL
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 1:231 VIRGINIA AVE APT 2338
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3793
Mailing Address - Country:US
Mailing Address - Phone:302-373-4426
Mailing Address - Fax:
Practice Address - Street 1:1800 FORT HARRISON RD
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-1413
Practice Address - Country:US
Practice Address - Phone:812-233-3751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014840A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice