Individual provider Active NPI

Arthur A Broderson, DDS

  • General Practice Dentistry
  • Inver Grove Heights, MN
National Provider Identifier
1104814003
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7757 Issued in MN
Practice address
6665 Cahill Ave
Inver Grove Heights, MN 55076-2026
Phone
(651) 455-1247
Fax
(651) 455-8375
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7757 MN Primary

Addresses

Primary practice location

6665 Cahill Ave
Inver Grove Heights, MN 55076-2026

Mailing address

PO Box 2005
Inver Grove Heights, MN 55076-8005
Phone (651) 455-1247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7757MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104814003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2005",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550768005",
            "telephone_number": "651-455-1247",
            "fax_number": "651-455-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6665 CAHILL AVE",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550762026",
            "telephone_number": "651-455-1247",
            "fax_number": "651-455-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERSON",
        "first_name": "ARTHUR",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "7757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inver Grove Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.