Individual provider Active NPI

Broc Allan Mushet, D.D.S.

  • General Practice Dentistry
  • Port Hueneme, CA
National Provider Identifier
1255582797
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58914 Issued in CA
Practice address
1000 23Rd Ave BLDG 914
Port Hueneme, CA 93043-4300
Phone
(805) 982-5584
NPI assigned
Oct 2, 2008
Last updated
Sep 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 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 58914 CA Primary

Addresses

Primary practice location

1000 23Rd Ave BLDG 914
Port Hueneme, CA 93043-4300

Mailing address

16988 Rendezvous Cir
San Diego, CA 92127-7052
Phone (949) 422-3091

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
RESIDENTCAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1255582797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16988 RENDEZVOUS CIR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921277052",
            "telephone_number": "949-422-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 23RD AVE BLDG 914",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930434300",
            "telephone_number": "805-982-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSHET",
        "first_name": "BROC",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Hueneme, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.