MEDICARE: DR. BROOKLYN D THOMAS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	12015001A	IN

General Provider Information

NPI Number	:	1093647190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BROOKLYN D THOMAS DDS

Provider Business Mailing Address
First Line	:	9670 E WASHINGTON ST STE 220
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-3051
Country	:	US
Telephone Number	:	317-897-1147
Fax Number	:

Provider Business Practice Location Address
First Line	:	9670 E WASHINGTON ST STE 220
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-3051
Country	:	US
Telephone Number	:	317-897-1147
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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