NPIMap

Organization Active NPI

Frederick W. Broadhead, DMD, PC

  • Dental Clinic/Center
  • Front Royal, VA
National Provider Identifier
1841536364
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
0401411086 Issued in VA
Legal business name
FREDERICK W. BROADHEAD, DMD, PC
Practice address
80 W 4TH St
Front Royal, VA 22630-2608
Phone
(540) 635-4567
Fax
(540) 635-6794
NPI assigned
Jan 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Authorized official

Name
Dr. Frederick Wright Broadhead, DMDNPI 1811187362
Title
Owner
Phone
(540) 635-4567

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 0401411086 VA Primary
Dental Clinic/Center 261QD0000X 0401413785 VA

Addresses

Primary practice location

80 W 4TH St
Front Royal, VA 22630-2608

Mailing address

80 W 4TH St
Front Royal, VA 22630-2608
Phone (540) 635-4567

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1841536364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 W 4TH ST",
            "city": "FRONT ROYAL",
            "state": "VA",
            "postal_code": "226302608",
            "telephone_number": "540-635-4567",
            "fax_number": "540-635-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 W 4TH ST",
            "city": "FRONT ROYAL",
            "state": "VA",
            "postal_code": "226302608",
            "telephone_number": "540-635-4567",
            "fax_number": "540-635-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK W. BROADHEAD, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "BROADHEAD",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "WRIGHT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-635-4567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "VA",
            "license": "0401411086",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "VA",
            "license": "0401413785",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Front Royal, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.