Andrew Brodek, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001881-15 Issued in WI

Practice address

413 W Washington Ave
Madison, WI 53703-2703

Phone

(608) 251-8790

NPI assigned

Jul 2, 2018

Last updated

Feb 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dentistry for Madison, LLC

  • General Practice Dentistry
  • Madison, WI
  • NPI 1669640108
  NPD (past)

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1932695913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EASTBOURNE CIR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171094",
            "telephone_number": "262-930-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032703",
            "telephone_number": "608-251-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODEK",
        "first_name": "ANDREW",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001881-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Bro
• Joshua Randall Brock
• Dale W Brockman, DC
• Kate Brockman, ATR, LCPC
• Christen Brockner, LPC
• Taylor Broder, APRN
• Kristin Broderick
• Lynn S Broderick, MD
• Thomas P Broderick, MD
• Jennifer Broders, PHARMD

• General Practice Dentistry in Madison, WI
• Providers in Madison, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.