Michele Broder, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

G1-0001021 Issued in DE

Practice address

2300 Pennsylvania Ave
Suite 5C
Wilmington, DE 19806-1392

Phone

(302) 652-1533

NPI assigned

Jul 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023036910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 PENNSYLVANIA AVE",
            "address_2": "SUITE 5C",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198061392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 PENNSYLVANIA AVE",
            "address_2": "SUITE 5C",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198061392",
            "telephone_number": "302-652-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODER",
        "first_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "DE",
            "license": "G1-0001021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Ann Olivia Broadway
• Paige Ariana Brocato, DPT
• Paul Michael Brock III, PA-C
• Sarah Brock
• Zachary Brock, PA-C
• Caitlin Brogan, MS, OTR/L
• Emily Elizabeth Brokaw, M.S., CCC-SLP
• Kristen Nicole Brokaw, COTA L
• Penni Brommer
• Kerry A Bron, MD

• Periodontics in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Periodontics in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.