Broadway Dentist LLC
Clinic/Center, Dental in Everett, Massachusetts
1235381302- Practice location
- 609 Broadway, Everett, MA 02149-3712
- Phone
- 617-389-3636
- Fax
- —
- Last updated
- October 21, 2008
Broadway Dentist LLC is a healthcare organization based in Everett, MA. Broadway Dentist LLC practices in Everett, MA. The NPI Number for Broadway Dentist LLC is 1235381302 and holds a License No. 21366 (MA). The current practice location address for Broadway Dentist LLC is 609 Broadway, Everett, MA 02149-3712 and can be reached out via phone at 617-389-3636.
Provider Profile Details
- NPI Number
- 1235381302
- Provider Name
- Broadway Dentist LLC
- Provider Entity Type
- Organization
- Address
- 609 Broadway, Everett, MA 02149-3712
- Phone Number
- 617-389-3636
- Primary Taxonomy
- Clinic/Center, Dental · 261QD0000X
- Organization Subpart
- No
- Authorized Official
- Peter Itkes · Manager · 617-694-1614
- Provider Enumeration Date
- October 21, 2008
- Last Update Date
- October 21, 2008
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 609 Broadway
Everett, MA 02149-3712 - City
- Everett
- State
- Massachusetts
- Zip
- 02149-3712
- Phone Number
- 617-389-3636
Provider Business Mailing Address Details
- Address
- 609 Broadway
Everett, MA 02149-3712 - City
- Everett
- State
- MA
- Zip
- 02149-3712
- Phone Number
- 617-389-3636
License Information
- License Number
- 21366
- License State
- MA
- Taxonomy
- Clinic/Center, Dental · 261QD0000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Broadway Dentist LLC?
The NPI number of Broadway Dentist LLC is 1235381302. It was assigned on October 21, 2008 and is currently active in the NPPES registry.
What is the specialty of Broadway Dentist LLC?
Broadway Dentist LLC is registered under the primary taxonomy Clinic/Center, Dental (code 261QD0000X), licensed in MA under license number 21366.
Where does Broadway Dentist LLC practice?
The practice location is 609 Broadway, Everett, MA 02149-3712. The office can be reached at 617-389-3636 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1235381302 directly on the NPPES registry website.