DR. DAVID BROCKBANK (NPI# 1982086807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982086807 |
| Entity Type | Individual |
| Full Name | DR. DAVID BROCKBANK |
| Credential | D.D.S. |
| Practice Address |
221 3rd St W Randolph Afb TX 78150 |
| Mailing Address |
4700 Las Vegas Blvd N Nellis Afb NV 89191-6600 |
| Practice Telephone | 8504435707 |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2018-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 30959 | TX | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
30959 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710222310 | David Joshua Brockbank | Nurse Practitioner | 441 S Redwood Rd, Salt Lake City, UT 84104-3539 | 2012-12-07 |
| 1093822561 | David Thomas Brockbank | Ophthalmology | 6065 Fashion Blvd, Ste 125, Murray, UT 84107-7381 | 2006-08-23 |
| Street Address |
221 3RD ST W |
| City | RANDOLPH AFB |
| State | TX |
| Zip Code | 78150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780228015 | Garrett R Lyman | Physician Assistant | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2019-10-30 |
| 1972074102 | Alexander Louis Nestor | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-12-16 |
| 1861973349 | Kimberli M Molina | Physician Assistant | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-08-23 |
| 1225526668 | Jon Paul Fitzgerald | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2018-05-01 |
| 1326587494 | Jonathan Madden | Military Health Care Provider | 221 3rd St W, Randolph Afb, TX 78150 | 2017-02-22 |
| 1508308685 | Stephanie Jean Campos | Registered Nurse | 221 3rd St W, Randolph Afb, TX 78150 | 2016-11-07 |
| 1568915643 | Shanna Leah Irizarry-miller | Nurse Practitioner | 221 3rd St W, Randolph Afb, TX 78150 | 2016-07-26 |
| 1215396072 | Kelly L. Riegleman | General Practice | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2016-02-22 |
| 1528488558 | Maxwell Dickey | Preventive Medicine | 221 3rd St W, Randolph Afb, TX 78150-4800 | 2014-04-17 |
| 1740619923 | Michael Prater | Pharmacist | 221 3rd St W, Bldg 1040 Rm 1d201, Randolph Afb, TX 78150-4800 | 2013-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045833 | Erica Renae Guevara | Physician Assistant | 559 Medial Sq, 221 Third Street West Bldg. 1040, Jbsa-randolph Afb, TX 78150 | 2019-04-05 |
| 1457803868 | Emily Newman | Dietitian, Registered | 221 Third Street West, Bldg. 999 Ste 2, Joint Base San Antonio -randolph, TX 78150 | 2016-11-02 |
| 1922411677 | Amber Drewer | Military Health Care Provider | 3rd Street West Building 1040, Randolph Afb, TX 78150 | 2014-06-10 |
| 1144652975 | Josephine Kimberly Olsen | Family Medicine | 359 Mdos/mdg, Randolph Afb, TX 78150 | 2013-08-02 |
| 1609149681 | Lucky Lusterio | Preventive Medicine | 221 3rd St. W, Randolph Afb, TX 78150 | 2012-02-21 |
| 1417120569 | Joni Hodgson | General Practice | 221 3rd Street West, Jbsa Randolph, TX 78150 | 2008-04-09 |
| 1710095724 | Katherine Justen Adamson | Physician Assistant | 12th Medical Group, 221 3rd Street West, Randolph Air Force Base, TX 78150 | 2006-08-29 |
| 1811950090 | Lidia Stana Ilcus | Internal Medicine | 359 Mdg, 221 Third Street West, Randolph Afb, TX 78150 | 2006-04-10 |
| 1013970672 | David Hamilton | Social Worker | 12mdos/sgohf, Randolph Afb, TX 78150 | 2006-04-06 |
| 1962465526 | Robert Allan Briggs | Physical Therapist | Randolph Afb Clinic, 221 3rd St W, Randolph Afb, TX 78150 | 2006-04-06 |
| Find all providers in zip 78150 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114447869 | Cherry Choy | Dentist | 359 Medical Group, 221 3rd Street West, Randolph Afb, TX 78150 | 2017-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366064 | Felipe Gregorio Flores | Dentist | 107 Shorecliff Dr, Portland, TX 78374-1459 | 2020-11-02 |
| 1659971653 | Richardson Heights Dental, Pllc | Dentist | 721 W Arapaho Rd Ste 101, Richardson, TX 75080-4155 | 2020-10-28 |
| 1053911396 | Ko Dental Group, PC | Dentist | 302 S. Avenue Q, Clifton, TX 76634 | 2020-10-27 |
| 1972103240 | Kla Dr Pllc | Dentist | 2100 Dallas Pkwy Ste 120, Plano, TX 75093-4394 | 2020-10-27 |
| 1255930798 | Jpm Dental Conroe | Dentist | 2104 N Frazier St Ste 140, Conroe, TX 77301-1250 | 2020-10-24 |
| 1407455173 | Perla Dental of Kaufman Pa | Dentist | 380 E Us Highway 175, Kaufman, TX 75142-3548 | 2020-10-22 |
| 1497354179 | Perla Dental of Keller Pa | Dentist | 5325 Golden Triangle Blvd Ste 100, Fort Worth, TX 76244-4469 | 2020-10-22 |
| 1770182701 | Summit Point Dental & Implant Center | Dentist | 3124 West University Drive, Mckinney, TX 75071-7507 | 2020-10-21 |
| 1760081954 | Amlan Pankaj | Dentist | 802 E Amarillo Blvd # 300, Amarillo, TX 79107-5401 | 2020-10-20 |
| 1114525581 | Ashley Roy | Dentist | 9099 Katy Fwy Ste 180, Houston, TX 77024-1677 | 2020-10-16 |
| Find all providers with the same taxonomy | ||||
| City | RANDOLPH AFB |
| Zip Code | 78150 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.