Jeffrey Greg Broermann, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5738 Issued in OK

Practice address

6585 S Yale Ave Ste 510
Tulsa, OK 74136

Phone

(918) 492-1106

NPI assigned

Dec 11, 2006

Last updated

Dec 12, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fox Broermann Pediatric Dentistry of Tulsa

  dba Smith & Fox Broermann

  • Pediatric Dentistry
  • Tulsa, OK
  • NPI 1114249190
  NPD
• Jerry W. Smith DDS Inc

  • Pediatric Dentistry
  • Tulsa, OK
  • NPI 1851485494
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1245390426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6585 S YALE AVE STE 510",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368384",
            "telephone_number": "918-492-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6585 S YALE AVE STE 510",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74136",
            "telephone_number": "918-492-1106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 S Yale Ave",
            "address_2": "Ste 401",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741368327",
            "country_code": "US",
            "telephone_number": "918-492-1106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6565 S Yale Ave",
            "address_2": "Ste 401",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741368327",
            "country_code": "US",
            "telephone_number": "918-492-1106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROERMANN",
        "first_name": "JEFFREY",
        "middle_name": "GREG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200084840A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Brock, PT
• Kendall Rhys Brock, SLP CF
• Leandra Sue Brock, RN
• Todd Alan Brockman, M.D.
• Elizabeth Page Brockwell, LCSW
• Michelle Denise Brogdon
• Molly Megan Brogdon, APRN
• Broken Arrow Medical Group LLC
• Broken Arrow Medical LLC
• Broken Arrow Orthopedics Inc

• Dentist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.