Jennifer Bass Brooks, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

64234 Issued in CA

Practice address

508 Red Hill Ave
San Anselmo, CA 94960-2436

Phone

(415) 457-2244

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jennifer Lynn Bass Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Dr. Brooks Dental Corp

  • Dental Clinic/Center
  • San Anselmo, CA
  • NPI 1972993657
  NPD (past) Authorized official
• David P Van Peursem DDS a Professional Corporation

  • General Practice Dentistry
  • San Anselmo, CA
  • NPI 1427172832
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1326192030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 RED HILL AVE",
            "address_2": "STE 1",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602473",
            "telephone_number": "415-457-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 RED HILL AVE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602436",
            "telephone_number": "415-457-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JENNIFER",
        "middle_name": "BASS",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012975",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "64234",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BASS",
            "middle_name": "LYNN",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lester Marc Bornheim, B.S,, PHD
• Boyer B. Cole, N.D., Naturopathic Medical Doctor
• Kate E Brennan, MFT
• David Brody, MD
• Michael Broffman, LAC
• Diane Hazelton Brown, PH.D.
• Kathryn Burke, L.AC.
• Carla Burman, MFT
• Stephanie Burns Burns
• Hollis Ann Byers, LMFT

• General Practice Dentistry in San Anselmo, CA
• Providers in San Anselmo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; 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.