Brosnan Dental LTD

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

19A12667 Issued in IL

Legal business name

BROSNAN DENTAL LTD

Practice address

10522 S Cicero Ave
Suite 204
Oak Lawn, IL 60453-5200

Phone

(708) 952-9185

Fax

(708) 952-9186

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James Glen Brosnan, D.D.S.

Title

President

Phone

(708) 952-9185

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962581736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10522 S CICERO AVE",
            "address_2": "SUITE 204",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535200",
            "telephone_number": "708-952-9185",
            "fax_number": "708-952-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10522 S CICERO AVE",
            "address_2": "SUITE 204",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535200",
            "telephone_number": "708-952-9185",
            "fax_number": "708-952-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROSNAN DENTAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROSNAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "GLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-952-9185",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "19A12667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell James Broderick, RPH
• Amber Marie Brodko
• Norbert Edward Brodzinski, RPH
• Abraham J Bronner, M.D.
• Terrell Brookins
• Joseph W Brosnan, MD
• Nolan Broussard, MD
• Brianna Ashley Brown
• Candace Brown, ED.D.
• Joanne K Brown, APN, ACNP-BC

• Dental Clinic/Center in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.