Everett Brokaw, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019034759 Issued in IL

Practice address

228 E Main St
Knoxville, IL 61448-1351

Phone

(999) 999-9999

NPI assigned

Jun 13, 2017

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• East Belmont Dental

  • Dentist
  • Knoxville, IL
  • NPI 1750248514
  NPD Authorized official
• Henderson County Rural Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Monmouth, IL
  • NPI 1144987975
  NPD (past)
• Henderson County Rural Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Stronghurst, IL
  • NPI 1972662658
  NPD (past)

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1205366242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 E MAIN ST",
            "city": "KNOXVILLE",
            "state": "IL",
            "postal_code": "614481351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 E MAIN ST",
            "city": "KNOXVILLE",
            "state": "IL",
            "postal_code": "614481351",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 Market St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Sunbury",
            "state": "PA",
            "postal_code": "178013411",
            "country_code": "US",
            "telephone_number": "999-999-9999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROKAW",
        "first_name": "EVERETT",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019034759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcus Bailey
• County of Knox
• County of Knox Knoxville Com Unit School Dist 202
• Annabelle Dayola-Ledford, APN
• East Belmont Dental
• Victoria Ann Fry

• All providers in Knoxville, IL
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; 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.