NPIMap

Organization Active NPI

Broadway Oral Surgery LLC

  • General Practice Dentistry
  • Newark, NJ
National Provider Identifier
1912869199
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BROADWAY ORAL SURGERY LLC
Practice address
223 Bloomfield Ave
Suite 2
Newark, NJ 07104
Phone
(973) 554-4565
NPI assigned
Nov 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Authorized official

Name
Mr. Michael Skolnick, DMD
Title
Owner
Phone
(908) 469-9100

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

223 Bloomfield Ave
Suite 2
Newark, NJ 07104

Mailing address

223 Bloomfield Ave
Suite 2
Newark, NJ 07104
Phone (973) 554-4565

National Provider Directory

National Provider Directory
Tax ID family
Broadway Oral Surgery LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1764115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764115200000",
    "number": "1912869199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 BLOOMFIELD AVE",
            "address_2": "SUITE 2",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07104",
            "telephone_number": "973-554-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 BLOOMFIELD AVE",
            "address_2": "SUITE 2",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07104",
            "telephone_number": "973-554-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY ORAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-26",
        "last_updated": "2025-11-26",
        "status": "A",
        "authorized_official_last_name": "SKOLNICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-469-9100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "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": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; 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.