Timothy Michael Brooks, DENTIST

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10319 Issued in MN

Practice address

9801 Dupont Ave S
Suite 400
Bloomington, MN 55431-3100

Phone

(952) 881-8983

NPI assigned

May 16, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 29, 2015 through Apr 29, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699982355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 DUPONT AVE S",
            "address_2": "SUITE 400",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313100",
            "telephone_number": "952-881-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 DUPONT AVE S",
            "address_2": "SUITE 400",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313100",
            "telephone_number": "952-881-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Broker, MD
• Anna Joye Brokofsky, MD
• Lauren Broksieck, PA-C
• Anne M Brooker, PA-C
• David Robert Brooks, M.D.
• Gerald A Brost, DDS
• Kyle Brougham, M.D.
• Charles Higgins Brower, MD
• Ashley Brown, PHARM D
• Barbara A Brown, GNP

• General Practice Dentistry in Bloomington, MN
• Providers in Bloomington, MN by specialty
• General Practice Dentistry in Minnesota

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.