Provider Demographics
NPI:1487787495
Name:BROOKS, SHARON L (DDS MS)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:L
Last Name:BROOKS
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1012
Mailing Address - Country:US
Mailing Address - Phone:734-764-1595
Mailing Address - Fax:734-764-2469
Practice Address - Street 1:1011 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1012
Practice Address - Country:US
Practice Address - Phone:734-764-1595
Practice Address - Fax:734-764-2469
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901010400122300000X, 1223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID010400OtherBCBS OF MI DENTAL
MID010400OtherBCBS OF MI DENTAL