Dr. John G Broderick, DMD
Dentist, Periodontics in Providence, Rhode Island
1841403953- Practice location
- 167 Gano St, Providence, RI 02906-3808
- Phone
- 401-274-2600
- Fax
- 401-421-7875
- Last updated
- July 8, 2007
John G. Broderick is a Dentist, Periodontics based in Providence, RI. John G. Broderick practices in Providence, RI and has the professional credentials of DMD. The NPI Number for John G. Broderick is 1841403953 and holds a License No. DEN02700 (RI). The current practice location address for John G. Broderick is 167 Gano St, Providence, RI 02906-3808 and can be reached out via phone at 401-274-2600 and via fax at 401-421-7875.
Provider Profile Details
- NPI Number
- 1841403953
- Provider Name
- John G. Broderick
- Credential
- DMD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 167 Gano St, Providence, RI 02906-3808
- Phone Number
- 401-274-2600
- Fax Number
- 401-421-7875
- Primary Taxonomy
- Dentist, Periodontics · 1223P0300X
- Sole Proprietor
- No
- Provider Enumeration Date
- May 7, 2007
- Last Update Date
- July 8, 2007
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 167 Gano St
Providence, RI 02906-3808 - City
- Providence
- State
- Rhode Island
- Zip
- 02906-3808
- Phone Number
- 401-274-2600
- Fax Number
- 401-421-7875
Provider Business Mailing Address Details
- Address
- 200 Heroux Blvd Unit 507
Cumberland, RI 02864-2384 - City
- Cumberland
- State
- RI
- Zip
- 02864-2384
- Phone Number
- 401-954-7760
- Fax Number
- 401-421-7875
License Information
- License Number
- DEN02700
- License State
- RI
- Taxonomy
- Dentist, Periodontics · 1223P0300X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dentist, Periodontics providers near Providence, RI
View all Dentist, Periodontics providers in Providence →- Boustani Periodontics PCDentist, Periodontics · NPI 1114745155
- City Dental, LLCDentist, Periodontics · NPI 1477736452
- Dr. David A Pezzullo, DMDDentist, Periodontics · NPI 1831101989
- Dr. Scott M Fertik, DDSDentist, Periodontics · NPI 1982810214
- Erica Kleinbaum, DMDDentist, Periodontics · NPI 1558927228
- Periodontal Associates, LTD.Dentist, Periodontics · NPI 1801206677
Frequently Asked Questions
What is the NPI number of Dr. John G Broderick, DMD?
The NPI number of Dr. John G Broderick, DMD is 1841403953. It was assigned on May 7, 2007 and is currently active in the NPPES registry.
What is the specialty of Dr. John G Broderick, DMD?
Dr. John G Broderick, DMD is registered under the primary taxonomy Dentist, Periodontics (code 1223P0300X), licensed in RI under license number DEN02700.
Where does Dr. John G Broderick, DMD practice?
The practice location is 167 Gano St, Providence, RI 02906-3808. The office can be reached at 401-274-2600 (phone) or 401-421-7875 (fax).
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 1841403953 directly on the NPPES registry website.