Individual provider Active NPI

Brooke N Adams, DDS

  • Dentist
  • Indianapolis, IN
National Provider Identifier
1275643371
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011104A Issued in IN
Practice address
1121 W Michigan Street
Ds307B
Indianapolis, IN 46202-5186
Phone
(615) 373-8001
Fax
(615) 371-9589
NPI assigned
Aug 30, 2006
Last updated
Nov 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8370 TN
Dentist 122300000X 12011104A IN Primary

Addresses

Primary practice location

1121 W Michigan Street
Ds307B
Indianapolis, IN 46202-5186

Mailing address

1121 W Michigan Street
Ds307
Indianapolis, IN 46202-5186
Phone (317) 278-3632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160915001007 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4688960701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8370TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University PastSince Sep 25, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1275643371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN STREET",
            "address_2": "DS307",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025186",
            "telephone_number": "317-278-3632",
            "fax_number": "317-274-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN STREET",
            "address_2": "DS307B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025186",
            "telephone_number": "615-373-8001",
            "fax_number": "615-371-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "BROOKE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "8370",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011104A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.