Healthcare Provider Details

I. General information

NPI: 1841214087
Provider Name (Legal Business Name): UNTRAY TYRONE BROWN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 PARNASSUS AVE
SAN FRANCISCO CA
94143-2210
US

IV. Provider business mailing address

55 GREENE AVE STE C
BROOKLYN NY
11238-6406
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-3276
  • Fax:
Mailing address:
  • Phone: 718-230-7676
  • Fax: 718-230-7776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number046243
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number51801
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: