Provider Demographics
NPI:1255823456
Name:DEXTER, BROOKLYNN ASHLEY (DDS)
Entity type:Individual
Prefix:
First Name:BROOKLYNN
Middle Name:ASHLEY
Last Name:DEXTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 30TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-4015
Mailing Address - Country:US
Mailing Address - Phone:308-338-2050
Mailing Address - Fax:
Practice Address - Street 1:118 W FRONT ST
Practice Address - Street 2:
Practice Address - City:ELM CREEK
Practice Address - State:NE
Practice Address - Zip Code:68836-7634
Practice Address - Country:US
Practice Address - Phone:308-856-1050
Practice Address - Fax:308-338-2055
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7455122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE7455OtherSTATE OF NE DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH