Thomas Glenn Brooks, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6262 Issued in OR

Practice address

492 Second Ave
Gold Hill, OR 97525-0198

Phone

(541) 855-7920

Fax

(541) 855-2511

NPI assigned

Mar 2, 2007

Last updated

Jul 8, 2007By 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

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.

• Applegate Valley Dental, Inc.

  • General Practice Dentistry
  • Jacksonville, OR
  • NPI 1477939494
  Authorized official Same address or phone
• Gold Hill Family Dentistry, LLC

  • General Practice Dentistry
  • Gold Hill, OR
  • NPI 1760017263
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306974035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198",
            "city": "GOLD HILL",
            "state": "OR",
            "postal_code": "975250198",
            "telephone_number": "541-855-7920",
            "fax_number": "541-855-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 SECOND AVE",
            "city": "GOLD HILL",
            "state": "OR",
            "postal_code": "975250198",
            "telephone_number": "541-855-7920",
            "fax_number": "541-855-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "THOMAS",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "D6262",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Cross DPT, LLC
• Brenda L Daugherty
• Chelsey Dow, BSN, RN
• Ana L Foster, RN
• Glenn Alexander Frum, R.PH.
• Gold Hill Family Dentistry, LLC

• General Practice Dentistry in Gold Hill, OR
• Providers in Gold Hill, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.