Organization Active NPI

North Broadway Dental LTD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1275702854
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NORTH BROADWAY DENTAL LTD
Practice address
5852 N Broadway St.
Ste. 1
Chicago, IL 60660
Phone
(773) 878-2970
Fax
(773) 878-8597
NPI assigned
Feb 27, 2008
Last updated
Sep 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Authorized official

Name
Joanna Tran
Title
Office Manager
Phone
(773) 878-2970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

5852 N Broadway St.
Ste. 1
Chicago, IL 60660

Mailing address

5852 N Broadway St.
Ste. 1
Chicago, IL 60660
Phone (773) 878-2970

National Provider Directory

National Provider Directory

Locations

5852 N Broadway St
Ste 1
Chicago, IL 60660
Phone (773) 878-2970

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1275702854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5852 N BROADWAY ST.",
            "address_2": "STE. 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60660",
            "telephone_number": "773-878-2970",
            "fax_number": "773-878-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5852 N BROADWAY ST.",
            "address_2": "STE. 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60660",
            "telephone_number": "773-878-2970",
            "fax_number": "773-878-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BROADWAY DENTAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "773-878-2970"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.