Provider Demographics
NPI:1871516195
Name:BROOKINS, DON EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:EDWARD
Last Name:BROOKINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 19TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5927
Mailing Address - Country:US
Mailing Address - Phone:972-578-1944
Mailing Address - Fax:972-422-4050
Practice Address - Street 1:1225 19TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5927
Practice Address - Country:US
Practice Address - Phone:972-578-1944
Practice Address - Fax:972-422-4050
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX008058201Medicaid