Broadway Dental Center PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI02292800 Issued in NJ

Legal business name

BROADWAY DENTAL CENTER PC

Practice address

15 Broadway
Suite 202
Passaic, NJ 07055-5007

Phone

(973) 777-1202

NPI assigned

Aug 9, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Sunitha Murthy, DDSNPI 1497979157

Title

Owner

Phone

(973) 777-1202

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Broadway Dental Center Doing business as

Locations

Practitioners 1

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

• Sunitha Murthy, DDS

  • Dentist
  • Passaic, NJ
  • NPI 1497979157
  NPD (past) Authorized official

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1518246453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BROADWAY",
            "address_2": "SUITE 202",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555007",
            "telephone_number": "973-777-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BROADWAY",
            "address_2": "SUITE 202",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555007",
            "telephone_number": "973-777-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY DENTAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "MURTHY",
        "authorized_official_first_name": "SUNITHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-777-1202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI02292800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0409961",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holanda P Bravo, M.D.
• Alan Brewster, D.C.
• Deborah Brickman, MS, RD, CDN, CDCES
• James Brief, M.D.
• Rebecca Brisman, CCC-SLP
• Broadway Dental Center, LLC
• Broadway Family Dental LLC
• Robyn Brody
• Shoshana Brody
• Tova Brody, LCSW

• General Practice Dentistry in Passaic, NJ
• Providers in Passaic, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.