NPIMap

Organization Active NPI

DRS.Brokaw and German

  • Dentist
  • Dixon, IL
National Provider Identifier
1114472297
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019018857 Issued in IL
Legal business name
DRS.BROKAW AND GERMAN
Practice address
123 N Hennepin Ave
Dixon, IL 61021-2010
Phone
(815) 284-6807
NPI assigned
Aug 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Mrs. Rebecca Bartlett
Title
Office Manager
Phone
(815) 284-6807

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 019018857 IL Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 019019615 IL

Addresses

Primary practice location

123 N Hennepin Ave
Dixon, IL 61021-2010

Mailing address

123 N Hennepin Ave
Dixon, IL 61021-2010
Phone (815) 284-6807

National Provider Directory

National Provider Directory

Locations

123 N Hennepin Ave
Dixon, IL 61021
Phone (815) 284-6807

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1114472297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N HENNEPIN AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610212010",
            "telephone_number": "815-284-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N HENNEPIN AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610212010",
            "telephone_number": "815-284-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS.BROKAW AND GERMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "BARTLETT",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "815-284-6807",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019018857",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019019615",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.