Individual provider Active NPI

Edward P. Broggi, DMD

  • General Practice Dentistry
  • Boynton Beach, FL
National Provider Identifier
1215955190
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN10457 Issued in FL
Practice address
1301 N Congress Ave Suite 110
Boynton Beach, FL 33426
Phone
(591) 292-0155
NPI assigned
Jul 18, 2006
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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 DN10457 FL Primary

Addresses

Primary practice location

1301 N Congress Ave Suite 110
Boynton Beach, FL 33426

Mailing address

1301 N Congress Ave Suite 110
Boynton Beach, FL 33426
Phone (591) 292-0155

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
DN10457FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Marianna Zadov, P.a PastSince Feb 13, 2022 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1215955190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N CONGRESS AVE SUITE 110",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "591-292-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N CONGRESS AVE SUITE 110",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "591-292-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGGI",
        "first_name": "EDWARD",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN10457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.