Andrew Ian Brodsky, DMD, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN1858022 Issued in MA

Practice address

25 High St
Milton, MA 02186-3426

Phone

(617) 696-7257

Fax

(617) 696-6635

NPI assigned

Jun 23, 2018

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

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529712000000",
    "number": "1548755481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HIGH ST",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021863426",
            "telephone_number": "617-696-7257",
            "fax_number": "617-696-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HIGH ST",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021863426",
            "telephone_number": "617-696-7257",
            "fax_number": "617-696-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODSKY",
        "first_name": "ANDREW",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-23",
        "last_updated": "2018-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "DN1858022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Bourgeois, PTA
• Jeffrey Bradley, MSW
• Ella Elisabeth Brandon, LICSW
• Brave Counseling & Wellness
• Brave Counseling & Wellness LLC
• Joshua Brody, M.D.
• Camden Brown
• Susan S Brown, LICSW
• Courtney Burke
• Beth Burnes, LICSW

• Periodontics in Milton, MA
• Providers in Milton, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.