Shandra Patrice Brooks, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

0000004921 Issued in TN

Practice address

BLDG 2441 21St Street
US Army Dental Activity
Fort Campbell, KY 42223

Phone

(270) 798-8977

Fax

(270) 956-0266

NPI assigned

Jun 10, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1629427596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5580 AIR ASSAULT AND DESERT STORM",
            "city": "FT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 2441 21ST STREET",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-8977",
            "fax_number": "270-956-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "SHANDRA",
        "middle_name": "PATRICE",
        "name_prefix": "Ms.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TN",
            "license": "4921",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "TN",
            "license": "0000004921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie A Brooks, PA
• Kenneth Brooks
• La-Shieka Brooks, LICSW
• Phillip Daniel Brooks, M.D.
• Portia Brooks
• Cameron Allen Brown, D.O.
• Greg Brown
• Jarrett Brown, PA-C
• Laytheater Michelle Brown, NURSE PRACTITIONER
• Matthew Christopher Brown, MD

• Dental Hygienist in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Dental Hygienist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.