Charles E Broadway, DMD, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN8829 Issued in FL

Legal business name

CHARLES E BROADWAY, DMD, PA

Practice address

1141 S Eustis St
Eustis, FL 32726-5558

Phone

(352) 589-2099

Fax

(352) 589-6046

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles Estes Broadway, DMDNPI 1902983018

Title

Dentist/Owner

Phone

(352) 589-2099

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Estes Broadway, D.M.D.

  • General Practice Dentistry
  • Eustis, FL
  • NPI 1902983018
  NPD (past) Authorized official
• Matthew Joseph Jackson, D.D.S.

  • General Practice Dentistry
  • Eustis, FL
  • NPI 1649499948
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740367879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 S EUSTIS ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327265558",
            "telephone_number": "352-589-2099",
            "fax_number": "352-589-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 S EUSTIS ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327265558",
            "telephone_number": "352-589-2099",
            "fax_number": "352-589-6046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES E BROADWAY, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROADWAY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ESTES",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "352-589-2099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN8829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadia Chambers
• Min-Ju Chan, OTR/L
• Suzette Ava Chandler, D.O.
• Terryl Christina Chandler
• Charlotte Chapman
• Charlotte Wigle, Arnp-C, P.a.
• Alisha Charmant
• Vladimir Chery, MD
• Childrens Therapy Place
• Kendall Aurelia Childs

• General Practice Dentistry in Eustis, FL
• Providers in Eustis, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.