MEDICARE: NICOLE BRUBAKER DMD

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	019.035468	IL

General Provider Information

NPI Number	:	1992494637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE BRUBAKER DMD

Provider Business Mailing Address
First Line	:	17-148 EDGEWATER DR
Second Line	:
City	:	LANARK
State	:	IL
Zip	:	61046-9366
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 MAIN ST
Second Line	:
City	:	SAVANNA
State	:	IL
Zip	:	61074-1535
Country	:	US
Telephone Number	:	815-273-2212
Fax Number	:

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

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	08/16/2024

Similar Medicare Providers

1447258355 — DR. WILLIAM J TONNE DDS
Practice Location Address:

401 MAIN ST
SAVANNA, IL
61074-1535

Practice Phone: 815-273-2212
Practice Fax: 815-273-2218

1073667184 — RIVERSIDE DENTAL, PC
Practice Location Address:

401 MAIN ST
SAVANNA, IL
61074-1535

Practice Phone: 815-273-2212
Practice Fax: 815-273-2218

1750640439 — KEITH RUTER LLC DBA RIVERSIDE DENTAL
Practice Location Address:

401 MAIN ST
SAVANNA, IL
61074-1535

Practice Phone: 815-273-2212
Practice Fax: 815-273-1081

1578559266 — LYNNETTE S JONES PT
Practice Location Address:

1121 N 5TH ST
SAVANNA, IL
61074-9732

Practice Phone: 815-273-7049
Practice Fax: 815-273-2575

1962491142 — RICHARD JOSEPH KEPPLER CRNA
Practice Location Address:

11508 HWY 52
SAVANNA, IL
61074

Practice Phone: 563-580-7366
Practice Fax:

1790768620 — TOM M KAO DC PC
Practice Location Address:

202 MAIN ST
SAVANNA, IL
61074-1628

Practice Phone: 815-273-5022
Practice Fax: 815-273-5022

Directions to “ NICOLE BRUBAKER DMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.