NPIMap

Organization Active NPI

Broadway Smiles Dental PC

  • General Practice Dentistry
  • Mount Vernon, NY
National Provider Identifier
1346739430
Registry record updated May 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BROADWAY SMILES DENTAL PC
Practice address
105 Stevens Ave Ste 302
Mount Vernon, NY 10550-2680
Phone
(914) 664-5955
NPI assigned
May 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2018

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

Authorized official

Name
Mrs. Pushpa Naik, DDS
Title
Dentist
Phone
(914) 664-5955

Specialties & licenses 1

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

Addresses

Primary practice location

105 Stevens Ave Ste 302
Mount Vernon, NY 10550-2680

Mailing address

105 Stevens Ave Ste 302
Mount Vernon, NY 10550-2680
Phone (914) 664-5955

National Provider Directory

National Provider Directory

Locations

105 Stevens Ave
Ste 302
Mount Vernon, NY 10550
Phone (914) 664-5955

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": "1525392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525392000000",
    "number": "1346739430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 STEVENS AVE STE 302",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502680",
            "telephone_number": "914-664-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 STEVENS AVE STE 302",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502680",
            "telephone_number": "914-664-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY SMILES DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-04",
        "last_updated": "2018-05-04",
        "status": "A",
        "authorized_official_last_name": "NAIK",
        "authorized_official_first_name": "PUSHPA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "914-664-5955",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; 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.