Broad Street Braces

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS039143 Issued in PA

Legal business name

BROAD STREET BRACES

Practice address

2010 S Juniper St
Philadelphia, PA 19148-5509

Phone

(201) 452-9270

NPI assigned

Jun 6, 2016

Last updated

Jun 6, 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. Neil Uffner, D.M.D, M.S.NPI 1245666007

Title

Orthodontist, Ownder

Phone

(201) 452-9270

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Neil Uffner, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Philadelphia, PA
  • NPI 1245666007
  Authorized official Same address or phone

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1649629189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 S JUNIPER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191485509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 S JUNIPER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191485509",
            "telephone_number": "201-452-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD STREET BRACES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "UFFNER",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "ORTHODONTIST, OWNDER",
        "authorized_official_telephone_number": "201-452-9270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D, M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS039143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028648360001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broad & Lehigh Pharmacy, Inc
• Broad and Grange Pharmacy
• Broad and Snyder Pharmacy P C (Broad and Snyder Pharmacy)
• Broad Health Center Inc.
• Broad St Pharmacy
• Broad Street Chiropractic & Wellness Center, LLC
• Broad Street Family Pharmacy
• Broad Street Medical LLC
• Broad Street Professional Medical Services LLC
• Broad Wellness and Chiropractic Center, P.C.

• Orthodontics and Dentofacial Orthopedics Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.