Broadway Dental, P.C. in Portland - Dental
Broadway Dental, P.C. - NPI 1043425697
Broadway Dental, P.C. is a Dental in Portland, Oregon. Broadway Dental, P.C. practices all healthcare services and medical treatments related to Dental. The NPI Number for Broadway Dental, P.C. is 1043425697. The last update date is 2020-08-22.
Broadway Dental, P.C.'s current location address is 1301 Ne Broadway St, Portland, Oregon. You can contact this provider via phone number 5032491100 and fax number 5032492969. The mailing address for Broadway Dental, P.C. is 1301 Ne Broadway St, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Broadway Dental, P.C. |
|---|---|
| Address | 1301 Ne Broadway St, Portland, Oregon |
| Phone Number | 5032491100 |
| Fax Number | 5032492969 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DENTIST |
|---|---|
| Authorized Official Name | Goodman-Cherrier Earl Edward |
| Credentials | DDS |
| Telephone Number | 5032491100 |
NPI Number Detail
| NPI Number | 1043425697 |
|---|---|
| Provider Enumeration Date | 2007-05-14 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1301 Ne Broadway St |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972321235 |
| Phone Number | 5032491100 |
| Fax Number | 5032492969 |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
| Licence No | D 5439 |
|
Definition: Provides general and specialized dental care and oral surgery. |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Broadway Dental, P.C. by the Centers for Medicare & Medicaid Services?
The Broadway Dental, P.C. has been issued the NPI (National Provider Identifier) 1043425697, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Broadway Dental, P.C. is located?
The Broadway Dental, P.C. is situated at the following address: 1301 Ne Broadway St, Portland, OR, 972321235.
What is Broadway Dental, P.C.'s specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Broadway Dental, P.C.'s specialized field of practice is Dental, and the corresponding taxonomy code that categorizes this area of specialization is 261Qd0000X.
On what date did the Broadway Dental, P.C. receive the assignment of its 1043425697 from the Centers for Medicare & Medicaid Services?
The Broadway Dental, P.C. was issued its 1043425697 by the Centers for Medicare & Medicaid Services on 2007-05-14.
As of what date was the information pertaining to Broadway Dental, P.C., such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Broadway Dental, P.C., including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-08-22.