Broomall Dental Health PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DSO-27446L Issued in PA

Legal business name

BROOMALL DENTAL HEALTH PC

Practice address

39 N Sproul Rd
Broomall, PA 19008-2512

Phone

(610) 356-8011

NPI assigned

Apr 17, 2013

Last updated

Apr 17, 2013By 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. Tom WatsonNPI 1528148384

Title

Owner/Dentist

Phone

(610) 356-8011

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, and the practitioner matching its NPPES authorized official.

• Tom C Watson, D.M.D.

  • General Practice Dentistry
  • Broomall, PA
  • NPI 1528148384
  NPD (past) Authorized official
• Nina A Blackhurst, D.M.D.

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1558780775
  NPD (past)

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366156800000",
    "number": "1952744260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 N SPROUL RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 N SPROUL RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082512",
            "telephone_number": "610-356-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOMALL DENTAL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-17",
        "last_updated": "2013-04-17",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "610-356-8011",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DSO-27446L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Stephen Brenner, O.D.
• Mark Prince Brigham, M.D.
• David Christopher Brooks, M.D., PH.D.
• Laura Winsor Brooks, P.A.
• Broomall Care Center LLC (Marple Gardens Rehabilitation and Nursing Center)
• Broomall Eye Care, P.C.
• Broomall Healthcare Group, Inc. (Broomall Manor)
• Broomall Medical Group, PC
• Broomall Operating Company LP (Broomall Rehabilitation & Nursing Center)
• Broomall Radiology Associates PC (Main Line Open MRI)

• General Practice Dentistry in Broomall, PA
• Providers in Broomall, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.