Alexander Gregory Brodsky, DMD

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

D7465 Issued in OR

Practice address

3653 SE 34TH Ave
Portland, OR 97202-3034

Phone

(503) 988-4410

Fax

(503) 988-5642

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: abrodsky4653@direct.ochin.org

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063591931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10618 SW 43RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972196992",
            "telephone_number": "503-488-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3653 SE 34TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023034",
            "telephone_number": "503-988-4410",
            "fax_number": "503-988-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODSKY",
        "first_name": "ALEXANDER",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "OR",
            "license": "D7465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Broderick
• Sarah Broderick, ED.S., NCSP
• Samuel Egan Brodersen
• Cindy Brodner, M.A., CEAP, LPC
• Simone Brodner
• Elizabeth Brodsky, LMT
• Larissa M Brodsky, MD
• Matthew Aaron Brodsky, MD
• Peggy Brodsky
• Ruvin Gregory Brodsky, RDH

• Public Health Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• Public Health Dentistry in Oregon

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.