Broadway Family and Cosmetic Dentistry PSC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8731 Issued in KY

Legal business name

BROADWAY FAMILY AND COSMETIC DENTISTRY PSC

Practice address

556 N Broadway
Lexington, KY 40508-1761

Phone

(859) 253-3242

Fax

(859) 253-0025

NPI assigned

Apr 21, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Aprille Rasheda Nelson, DMDNPI 1073749248

Title

Owner

Phone

(859) 253-3242

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aprille Rasheda Nelson, D.M.D

  • General Practice Dentistry
  • Lexington, KY
  • NPI 1073749248
  NPD (past) Authorized official
• Carrie Bell Brown, D.M.D.

  • General Practice Dentistry
  • Lexington, KY
  • NPI 1710950621
  NPD (past)

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303344000000",
    "number": "1366733644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 N BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405081761",
            "telephone_number": "859-253-3242",
            "fax_number": "859-253-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 N BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405081761",
            "telephone_number": "859-253-3242",
            "fax_number": "859-253-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY FAMILY AND COSMETIC DENTISTRY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-21",
        "last_updated": "2011-04-21",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "APRILLE",
        "authorized_official_middle_name": "RASHEDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-253-3242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100149080",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Javonna Broadus
• John Douglas Broadus
• Marian Judith Broadus, PH. D.
• Broadway Clinic Pharmacy Inc
• Broadway Denture Center
• Jennifer Brocato, ARNP
• Jenna Rose Brock, MA, BCBA, LBA
• Jonathan Scott Brock
• Kyle Brock
• Mariya Nikolaevna Brock, APRN

• General Practice Dentistry in Lexington, KY
• Providers in Lexington, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.