Michael D Brooks, D.M.D., M.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DE00011225 Issued in WA

Practice address

19365 7TH Ave NE Ste 114
Poulsbo, WA 98370-7441

Phone

(360) 779-7414

Fax

(360) 779-7732

NPI assigned

Dec 28, 2005

Last updated

Jun 16, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Sep 12, 2016 through Sep 12, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael D Brooks DMD, Ms, PLLC

  dba Peninsula Prosthodontics

  • Dental Clinic/Center
  • Poulsbo, WA
  • NPI 1124267745
  Authorized official Same address or phone
• Brooksjohnsonpllc

  dba W.S.P.D.I.C

  • Prosthodontics
  • Spokane, WA
  • NPI 1144694787
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1083691273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19365 7TH AVE NE STE 114",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707441",
            "telephone_number": "360-779-7414",
            "fax_number": "360-779-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19365 7TH AVE NE STE 114",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707441",
            "telephone_number": "360-779-7414",
            "fax_number": "360-779-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "DE00011225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Margaret Briner
• Ryan Brinton, DPT
• Heidi Garoutte Brislin, OTR/L
• Scott A Broadbent, D.D.S.
• Jeffrey Brodie, M.D.
• Erin Allen Brower, MA,LMHC,CE
• Bernie Jay Brown, DO
• Charles R Brown, D.D.S
• Kaitlyn Brumbaugh
• Lydia Bruni

• Prosthodontics in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Prosthodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.