MEDICARE: DR. DAVID FALLS BROCKMAN 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	1223G0001X	General Practice Dentistry	10448	TN
2	122300000X	Dentist	2516	AR

General Provider Information

NPI Number	:	1801902531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID FALLS BROCKMAN DDS

Provider Business Mailing Address
First Line	:	62 CIMARRON VALLEY DR
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-3502
Country	:	US
Telephone Number	:	501-580-6646
Fax Number	:

Provider Business Practice Location Address
First Line	:	62 CIMARRON VALLEY DR
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-3502
Country	:	US
Telephone Number	:	501-580-6646
Fax Number	:

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	04/22/2026

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