Active NPI
Sara Elizabeth Brooks, RDH, BS
- Dental Hygienist
- Hannibal, MO
National Provider Identifier
1760065494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2013031274
- Practice address
- 9126 Idell Creek LN
Hannibal, MO 63401-6458 - Phone
- (217) 231-1179
- NPI assigned
- Apr 30, 2021
- Last updated
- Apr 30, 2021
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2013031274 | MO | Primary |
Addresses
Primary practice location
9126 Idell Creek LN
Hannibal, MO 63401-6458
Mailing address
9126 Idell Creek LN
Hannibal, MO 63401-6458
Phone (217) 231-1179
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013031274 | MO | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619740800000",
"number": "1760065494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9126 IDELL CREEK LN",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634016458",
"telephone_number": "217-231-1179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9126 IDELL CREEK LN",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634016458",
"telephone_number": "217-231-1179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "SARA",
"middle_name": "ELIZABETH",
"credential": "RDH, BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-30",
"last_updated": "2021-04-30",
"certification_date": "2021-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MO",
"license": "2013031274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hannibal, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.