Jeffory Lynn Broman, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1410689922 Issued in UT

Practice address

215 South 10TH East
Suite a
Salt Lake City, UT 84102

Phone

(801) 328-4173

Fax

(801) 322-3995

NPI assigned

Dec 29, 2008

Last updated

Dec 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Avenues Family Dentistry

  • General Practice Dentistry
  • Salt Lake City, UT
  • NPI 1093018111
  NPD (past)

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

{
    "created_epoch": "1230508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1518103340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SOUTH 10TH EAST",
            "address_2": "SUITE A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84102",
            "telephone_number": "801-328-4173",
            "fax_number": "801-322-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SOUTH 10TH EAST",
            "address_2": "SUITE A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84102",
            "telephone_number": "801-328-4173",
            "fax_number": "801-322-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMAN",
        "first_name": "JEFFORY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-29",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "1410689922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKayla Brog
• Kathryn Eisenhut Brogan, MD
• Shane Edward Brogan, MD
• Taylor Brohamer, OTR/L
• Belinda Brokke
• Mark B. Bromberg, M.D.,PH.D.
• Kaylee Bromell, OTR/L
• Liane Marissa Bromer, M.D.
• Catherine Bromley
• Mary P Bronner, MD

• Dentist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.