Jennifer K Brubaker, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027083 Issued in IL

Practice address

1099 Belt Line Rd
Suite a
Collinsville, IL 62234-4380

Phone

(618) 344-4527

Fax

(618) 344-7380

NPI assigned

Aug 19, 2006

Sex

Female

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ronald Weems Jr. P.C.

  • General Practice Dentistry
  • Collinsville, IL
  • NPI 1255659272
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1205940681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 BELT LINE RD",
            "address_2": "SUITE A",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344380",
            "telephone_number": "618-344-4527",
            "fax_number": "618-344-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 BELT LINE RD",
            "address_2": "SUITE A",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344380",
            "telephone_number": "618-344-4527",
            "fax_number": "618-344-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breastfeeding Support Services, Inc.
• Brighter Minds PLLC
• Sarah Margaret Broom, PHD
• Audrey Ruth Brown
• Connie Sue Brown, COTA L
• John Andrew Bukovac, DMD
• William Nathaniel Byrkit Jr., DC
• Sanna Calhoun, CCC/SLP-L
• Pearl Purino Campbell, MA
• Aida Castillo

• General Practice Dentistry in Collinsville, IL
• Providers in Collinsville, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.