Michael Louis Middlebrooks, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN 7934 Issued in FL

Practice address

4232 Baymeadows Rd
Jacksonville, FL 32217-4604

Phone

(904) 739-0690

Fax

(904) 737-1045

NPI assigned

Aug 29, 2005

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1700879442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4232 BAYMEADOWS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174604",
            "telephone_number": "904-739-0690",
            "fax_number": "904-737-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4232 BAYMEADOWS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174604",
            "telephone_number": "904-739-0690",
            "fax_number": "904-737-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLEBROOKS",
        "first_name": "MICHAEL",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 7934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent S Mickley, PA
• John Mickley
• Angelia Rose Miclat
• Victor C. Micolucci, M.D.
• Erik Hayden Middlebrooks, M.D.
• Jessica Middlekauff
• Heather Middleton, RDN, LD/N
• Kameron Middleton
• Martiza Middleton
• Saundra Middleton, DMD

• Oral and Maxillofacial Surgery (Dentist) in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.