Tanner Thomas Brolsma, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1274 Issued in SD

Practice address

2400 W 41St St
Sioux Falls, SD 57105-6119

Phone

(605) 679-7227

NPI assigned

Jun 30, 2020

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1891312435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 W WILSON DR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571067649",
            "telephone_number": "641-512-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W 41ST ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056119",
            "telephone_number": "605-679-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROLSMA",
        "first_name": "TANNER",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D1274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brendan Brodersen, DO
• Stephanie O. Broderson, MD
• Julie Brodkorb, COA
• Alex Wilson Broesder, DDS
• Nicholas Brokenleg
• Bethany Brooks
• Jamiey Brooks, PHARMD
• Lana Kay Brooks, CNP-BC
• Patricia Jo Brooks, MD
• Sherrie Marie Brooks, D.O.,FACC,FACOI

• General Practice Dentistry in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.