Provider Demographics
NPI:1275025603
Name:YOSSI, BROOKE ASHLEY (DDS)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ASHLEY
Last Name:YOSSI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:BROOKE
Other - Middle Name:ASHLEY
Other - Last Name:BERKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2302 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-5106
Mailing Address - Country:US
Mailing Address - Phone:515-964-8350
Mailing Address - Fax:515-964-9519
Practice Address - Street 1:2302 W 1ST ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-5106
Practice Address - Country:US
Practice Address - Phone:515-964-8350
Practice Address - Fax:515-964-9519
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS0095461223G0001X
IADDS095461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IADDS09546OtherSTATE
IADDS09546OtherDDS09546
IA09546OtherIOWA