Broadway Family Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BROADWAY FAMILY DENTAL LLC

Practice address

15 Broadway
Passaic, NJ 07055-5007

Phone

(973) 955-2002

NPI assigned

Oct 6, 2016

Last updated

Oct 10, 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. Priya Duggal, DMD

Title

Periodontist

Phone

(973) 955-2022

Specialties & licenses 6

Addresses

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1790235315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BROADWAY",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555007",
            "telephone_number": "973-955-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BROADWAY",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555007",
            "telephone_number": "973-955-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "DUGGAL",
        "authorized_official_first_name": "PRIYA",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "973-955-2022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI020689",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Brickman, MS, RD, CDN, CDCES
• James Brief, M.D.
• Rebecca Brisman, CCC-SLP
• Broadway Dental Center PC (Broadway Dental Center)
• Broadway Dental Center, LLC
• Robyn Brody
• Shoshana Brody
• Tova Brody, LCSW
• Chaim Bruder, SLP
• Kristina Bruno

• Dentist in Passaic, NJ
• Providers in Passaic, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.