NPIMap

Organization Active NPI

Broadway Dental LLC

Doing business as dba Smiles on Broadway

  • General Practice Dentistry
  • Tempe, AZ
National Provider Identifier
1356622435
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7840 Issued in AZ
Legal business name
BROADWAY DENTAL LLC
Doing business as
dba Smiles on Broadway
Practice address
55 E. Broadway
Tempe, AZ 85282
Phone
(480) 664-2244
Fax
(623) 236-9360
NPI assigned
Sep 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Authorized official

Name
Taroll A Graziano, B.S.
Title
Manager
Phone
(623) 556-7789

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X D7840 AZ
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D7840 AZ Primary

Addresses

Primary practice location

55 E. Broadway
Tempe, AZ 85282

Mailing address

3414 W. Union Hills Dr
Unit 8
Phoenix, AZ 85027
Phone (480) 664-2244

Other names 1

  • dba Smiles on Broadway Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Best Choice Dental LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1356622435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 W. UNION HILLS DR",
            "address_2": "UNIT 8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85027",
            "telephone_number": "480-664-2244",
            "fax_number": "623-236-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E. BROADWAY",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-664-2244",
            "fax_number": "623-236-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "GRAZIANO",
        "authorized_official_first_name": "TAROLL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "623-556-7789",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D7840",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D7840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Smiles on Broadway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.