Active NPI
Susan Rogers Brooks, D.D.S.
- Dentist
- Port Charlotte, FL
National Provider Identifier
1346393303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN12278
- Practice address
- 3440 Conway Blvd Ste 2a
Port Charlotte, FL 33952-7050 - Phone
- (941) 629-4311
- NPI assigned
- Jan 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN12278 | FL | Primary |
Addresses
Primary practice location
3440 Conway Blvd Ste 2a
Port Charlotte, FL 33952-7050
Mailing address
3440 Conway Blvd Ste 2a
Port Charlotte, FL 33952-7050
Phone (941) 629-4311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN12278 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gulf Coast Sleep Solutions LLC | Dentist | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215993600000",
"number": "1346393303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3440 CONWAY BLVD STE 2A",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339527050",
"telephone_number": "941-629-4311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3440 CONWAY BLVD STE 2A",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339527050",
"telephone_number": "941-629-4311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "SUSAN",
"middle_name": "ROGERS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-20",
"last_updated": "2008-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN12278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.