NPIMap

Organization Active NPI

Michael D Brooks DMD, Ms, PLLC

Doing business as Peninsula Prosthodontics

  • Dental Clinic/Center
  • Poulsbo, WA
National Provider Identifier
1124267745
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MICHAEL D BROOKS DMD, MS, PLLC
Doing business as
Peninsula Prosthodontics
Practice address
19365 7TH Ave NE Ste 114
Poulsbo, WA 98370-7441
Phone
(360) 779-7414
Fax
(360) 779-7732
NPI assigned
Feb 5, 2009
Last updated
Feb 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Authorized official

Name
Michael D Brooks, DMD, MS, PLLCNPI 1083691273
Title
Owner
Phone
(360) 779-7414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

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

Mailing address

19365 7TH Ave NE Ste 114
Poulsbo, WA 98370-7441
Phone (360) 779-7414

Other names 1

  • PENINSULA PROSTHODONTICS Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1124267745",
    "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": {
        "organization_name": "MICHAEL D BROOKS DMD, MS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-779-7414",
        "authorized_official_credential": "DMD, MS, PLLC"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PENINSULA PROSTHODONTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.