Scott a. Broadbent, D.D.S, P.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00006455 Issued in WA

Legal business name

SCOTT A. BROADBENT, D.D.S, P.S.

Practice address

19365 7TH Ave NE
Suite 110
Poulsbo, WA 98370-7441

Phone

(360) 697-3331

Fax

(360) 697-4610

NPI assigned

Sep 20, 2006

Last updated

Aug 14, 2012By 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

Lisa Olson

Title

Office Admistration

Phone

(360) 697-3331

Specialties & licenses 1

Addresses

Other names 1

• Village Dental Other name

Locations

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.

• Scott A Broadbent, D.D.S.

  • General Practice Dentistry
  • Poulsbo, WA
  • NPI 1083961536
  NPD (past)
• Nicholas Maniatis, DMD

  • Dentist
  • Poulsbo, WA
  • NPI 1265017867
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1699873844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19365 7TH AVE NE STE 110",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19365 7TH AVE NE",
            "address_2": "SUITE 110",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707441",
            "telephone_number": "360-697-3331",
            "fax_number": "360-697-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT A. BROADBENT, D.D.S, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-08-14",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE ADMISTRATION",
        "authorized_official_telephone_number": "360-697-3331"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melinda M Sauder, MSW, LSWAIC
• Sharon J. Schellinger
• Nik Schramm
• Jeannette M. Schreiber, L.AC.
• Scott a Olson DDS PLLC (Viking Dental)
• Scott Welling DDS PLLC (Nordic Family Dental)
• Christopher Brian Scott Jr., PHARM D.
• Madison D Scott, PA-C
• Seattle Pain Center Medical Corporation (Seattle Pain Center)
• David Scott Secrest, M.A.

• General Practice Dentistry in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.