NPIMap

Organization Active NPI

Broadway Dental

  • Dentist
  • Bronx, NY
National Provider Identifier
1568843290
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
054002 Issued in NY
Legal business name
BROADWAY DENTAL
Practice address
48 E Kingsbridge Rd
Bronx, NY 10468-7514
Phone
(718) 933-9603
NPI assigned
Jun 18, 2015
Last updated
Jun 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Authorized official

Name
Dr. Jack Brown, DDSNPI 1538315130
Title
Dentist
Phone
(516) 643-0424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 054002 NY Primary

Addresses

Primary practice location

48 E Kingsbridge Rd
Bronx, NY 10468-7514

Mailing address

48 E Kingsbridge Rd
Bronx, NY 10468-7514
Phone (718) 933-9603

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1568843290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 E KINGSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104687514",
            "telephone_number": "718-933-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 E KINGSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104687514",
            "telephone_number": "718-933-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "516-643-0424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.