Broadway Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5809 Issued in OK

Legal business name

BROADWAY DENTAL, LLC

Practice address

2104 N Broadway St
Poteau, OK 74953-2501

Phone

(918) 647-7080

NPI assigned

Mar 16, 2018

Last updated

Mar 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ayan Lawson, DMDNPI 1376606228

Title

Dentist

Phone

(918) 448-6083

Specialties & licenses 1

Addresses

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.

• Ayan Love Lawson, D.M.D

  • General Practice Dentistry
  • Wilburton, OK
  • NPI 1376606228
  NPD (past) Authorized official
• Ronald Nelson Hesser, D.D.S.

  • General Practice Dentistry
  • Poteau, OK
  • NPI 1588005037
  NPD (past)
• Casey Dillon Osterhout, DMD

  • General Practice Dentistry
  • Wilburton, OK
  • NPI 1073676862
  NPD (past)

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521158400000",
    "number": "1497258354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W MAIN ST",
            "city": "WILBURTON",
            "state": "OK",
            "postal_code": "745784044",
            "telephone_number": "918-465-3535",
            "fax_number": "918-465-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 N BROADWAY ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749532501",
            "telephone_number": "918-647-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "AYAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "918-448-6083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Branscum
• Angela Ann Breeding, OD
• Sherri Brickman
• Bright Skies Community Services Inc.
• Brighter Heights Oklahoma, LLC (Brighter Heights Oklahoma)
• Amber Brown
• Kimberly Dawn Brown
• Lori Deane' Brown
• Sheila Brown
• Shelly Marie Brown

• General Practice Dentistry in Poteau, OK
• Providers in Poteau, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.