Broadway Dental Arts PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

054305 Issued in NY

Legal business name

BROADWAY DENTAL ARTS PC

Practice address

738 Broadway
Brooklyn, NY 11206-4403

Phone

(212) 410-6969

Fax

(212) 410-6989

NPI assigned

Aug 3, 2012

Last updated

Aug 3, 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

Mattew Min Kuy Kim, DDS

Title

President

Phone

(212) 410-6969

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343952000000",
    "number": "1730435140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2071 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294101",
            "telephone_number": "212-410-6969",
            "fax_number": "212-410-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112064403",
            "telephone_number": "212-410-6969",
            "fax_number": "212-410-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY DENTAL ARTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-03",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MATTEW MIN KUY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-410-6969",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brmi @ Bensonhurst
• Brmi @ Boro Park
• Brmi @ Midwood
• Brmi @ Sunset Park
• Broadway Care Inc. (Broadway Pharmacy)
• Broadway Dental Health Boutique,P.C.
• Broadway Family Dental P.C.
• Broadway Pharmacy Inc (Wyckoff Drugs)
• Broadway RX LLC (Broadway Pharmacy)
• Julie Katherine Broadway-Spinner, PMHNP, RN-BC

• General Practice Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.