Broadway Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BROADWAY DENTAL

Practice address

144 Broadway
Revere, MA 02151-5349

Phone

(781) 284-2275

NPI assigned

Oct 30, 2008

Organization subpart

Yes

Parent organization

EUGENE BARK DMD AND ASSOCIATESAs reported in NPPES

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

Authorized official

Name

Eugene Bark

Title

Dentist

Phone

(781) 284-2275

Specialties & licenses 1

Addresses

Tax ID family

Broadway Dental2 organizations share this tax ID, including this one

Part of

Broadway Dental

Other organizations with this tax ID 1

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

• Eugene Bark DMD and Ssociates PC

  • Dentist
  • Roslindale, MA
  • NPI 1063668028
  NPD tax ID

Locations

Practitioners 1

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

• Leonid Kharin, DMD

  • General Practice Dentistry
  • Andover, MA
  • NPI 1205116514
  NPD (past)

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225324800000",
    "number": "1396998621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021515349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021515349",
            "telephone_number": "781-284-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EUGENE BARK DMD AND ASSOCIATES",
        "enumeration_date": "2008-10-30",
        "last_updated": "2008-10-30",
        "status": "A",
        "authorized_official_last_name": "BARK",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "781-284-2275"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boston Homecare LLC
• Suzanne Victoria Boxer, MD
• King Brangman
• Lisa Dondero Brengola, NP
• Scott Brizard, PHARMD, RPH
• Broadway Family Chiropractic, Inc
• Broadway Optical Corp
• Broadway Physical Therapy, Inc.
• Carol Broder
• Johane Brown, RN, FNP

• Dentist in Revere, MA
• Providers in Revere, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; 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.