James Sean Brodfuehrer, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

37535 Issued in CA

Practice address

9225 Mira Mesa Blvd
Suite #212
San Diego, CA 92126-4811

Phone

(858) 566-9452

Fax

(858) 566-9967

NPI assigned

Jan 18, 2007

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 CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cheraj Dental Corporation

  • Dentist
  • San Diego, CA
  • NPI 1811842859
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104978030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 MIRA MESA BLVD",
            "address_2": "SUITE #212",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264811",
            "telephone_number": "858-566-9452",
            "fax_number": "858-566-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9225 MIRA MESA BLVD",
            "address_2": "SUITE #212",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264811",
            "telephone_number": "858-566-9452",
            "fax_number": "858-566-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODFUEHRER",
        "first_name": "JAMES",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "37535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chasmal Tyesha Broderick
• David L. Broderick Jr., B.A.
• Kristy Rose Broderick, FNP-BC
• Lori Broderick, M.D., PH.D.
• Ryan C Broderick, M.D
• Fred Joseph Brodie, DIVE IDC
• Michelle Marie Brodie, MS
• Kyle Brodmann, M.D.
• Mark E Brodsky, MD
• Rachel Brodsky

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• 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.