Broadway Family Dental Presented by Dr. Tariq Sayegh BDS LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BROADWAY FAMILY DENTAL PRESENTED BY DR. TARIQ SAYEGH BDS LLC

Doing business as

Broadway Family Dental

Practice address

5716 Broadway Avenue
Cleveland, OH 44127-1715

Phone

(216) 862-4990

Fax

(216) 862-3585

NPI assigned

Feb 4, 2016

Last updated

Feb 4, 2016By 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. Tariq Sayegh Sayegh, D.D.S.

Title

Owner/Doctor

Phone

(440) 454-3536

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Broadway Family Dental Doing business as

Locations

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1639537616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 BROADWAY AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271715",
            "telephone_number": "216-862-4990",
            "fax_number": "216-862-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 BROADWAY AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271715",
            "telephone_number": "216-862-4990",
            "fax_number": "216-862-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY FAMILY DENTAL PRESENTED BY DR. TARIQ SAYEGH BDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "SAYEGH",
        "authorized_official_first_name": "TARIQ",
        "authorized_official_middle_name": "SAYEGH",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "14404543536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2943391",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Marie Broadbent
• Latoya Broadus
• Rose Ann Broadus
• Broadway Academy, Inc.
• Broadway Chiropractic and Therapy Center Inc
• Broadway Lifeforce Corporation (Broadway Orthopedics & Sports Medicine)
• Victoria Brobbey, MD
• Amber Brochetti, MPT
• Kevin Brochetti, DPT
• Jessica Taylor Brock, DO

• Dental Clinic/Center in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.