NPIMap

Organization Active NPI

Leonard Broverman DMD PC

  • General Practice Dentistry
  • Concord, MA
National Provider Identifier
1104983147
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11223 Issued in MA
Legal business name
LEONARD BROVERMAN DMD PC
Practice address
290 Baker Ave
Suite S101
Concord, MA 01742-2189
Phone
(978) 369-2062
Fax
(978) 369-0090
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Leonard Broverman, DMDNPI 1356408462
Title
President
Phone
(978) 369-2062

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 11223 MA Primary

Addresses

Primary practice location

290 Baker Ave
Suite S101
Concord, MA 01742-2189

Mailing address

45 Webster Cir
Sudbury, MA 01776-1275
Phone (978) 443-2636

National Provider Directory

National Provider Directory

Locations

290 Baker Ave
Ste S101
Concord, MA 01742
Phone (978) 369-2062

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104983147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WEBSTER CIR",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761275",
            "telephone_number": "978-443-2636",
            "fax_number": "978-443-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 BAKER AVE",
            "address_2": "SUITE S101",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422189",
            "telephone_number": "978-369-2062",
            "fax_number": "978-369-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEONARD BROVERMAN DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROVERMAN",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-369-2062",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "11223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.