New Broadway Dental

Primary specialty

DentistTaxonomy code 122300000X

License

050515 Issued in NY

Legal business name

NEW BROADWAY DENTAL

Practice address

1501 Broadway
New York, NY 10036-5601

Phone

(212) 398-1969

Fax

(212) 398-1971

NPI assigned

Mar 7, 2012

Organization subpart

No

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

Authorized official

Name

Natalya Modlin

Title

DDS

Phone

(201) 873-9898

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1134493182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100365601",
            "telephone_number": "212-398-1969",
            "fax_number": "212-398-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100365601",
            "telephone_number": "212-398-1969",
            "fax_number": "212-398-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BROADWAY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "MODLIN",
        "authorized_official_first_name": "NATALYA",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "201-873-9898"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "050515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.