NPIMap

Organization Active NPI

Broadway Oral Surgery, LLC

  • Dentist
  • Bayonne, NJ
National Provider Identifier
1427734680
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BROADWAY ORAL SURGERY, LLC
Practice address
925 Broadway
Bayonne, NJ 07002-3088
Phone
(201) 858-1400
NPI assigned
Jun 23, 2023
Last updated
Jun 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Authorized official

Name
Dr. Michael Skolnick, DMD
Title
Ceo
Phone
(201) 858-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

925 Broadway
Bayonne, NJ 07002-3088

Mailing address

925 Broadway
Bayonne, NJ 07002-3088
Phone (201) 858-1400

National Provider Directory

National Provider Directory
Tax ID family
Broadway Oral Surgery LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1687478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1427734680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023088",
            "telephone_number": "201-858-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023088",
            "telephone_number": "201-858-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY ORAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "SKOLNICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "201-858-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.