DOUGLAS JOHN BROCKMAN DDS NPI 1174583306

NPI Information

NPI: 1174583306
Provider Name: DOUGLAS JOHN BROCKMAN, DDS
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
210 S BREIEL BLVD
MIDDLETOWN, OH
ZIP 45044
Phone: (513) 423-9239
Get Directions

Douglas John Brockman, DDS is a pediatric dentistry dentist in Middletown, OH. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. Douglas John Brockman, DDS NPI is 1174583306. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

210 S BREIEL BLVD
MIDDLETOWN, OH
ZIP 45044-157
Phone: (513) 423-9239

The enumeration date for this NPI number is 3/23/2006 and was last updated on 11/24/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	18488	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0743637	MEDICAID	OHIO
2	0701379	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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