JAMES CHARLES BROADFOOT (NPI# 1174704837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174704837 |
| Entity Type | Individual |
| Full Name | JAMES CHARLES BROADFOOT |
| Credential | D.M.D. |
| Practice Address |
414 Pendleton Pl Valdosta GA 31602-2603 |
| Practice Telephone | 2292443700 |
| Practice Fax Number | 2292470373 |
| Mailing Telephone | 2292443700 |
| Mailing Fax Number | 2292470373 |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2007-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DN013666 | GA | Dental Providers |
| Street Address |
414 PENDLETON PL |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-2603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295978047 | Azalea City Family Dentistry | Dentist | 414 Pendleton Pl, Valdosta, GA 31602-2603 | 2009-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639528516 | Affordable Dentures & Implants - Valdosta, P.C. | Dentist | 282 Norman Dr Ste D, Valdosta, GA 31601-5493 | 2016-06-10 |
| 1497104871 | Hardy Lamar Gray | Dentist | 3362 Greystone Way, Valdosta, GA 31605-1096 | 2016-06-07 |
| 1518353846 | Mark A. Roland, Dmd PC | Dentist | 101 E Northside Dr, Suite D, Valdosta, GA 31602-1724 | 2015-04-14 |
| 1649683541 | Dustin Ross Kilby | Dentist | 2704 Oak Center Dr, Valdosta, GA 31605 | 2014-06-09 |
| 1053632224 | Stanley Todd Alderman | Dentist | 114 W Cranford Ave, Valdosta, GA 31602-2931 | 2010-06-22 |
| 1073760369 | Donald W. Garner | Dentist | 114 W. Cranford Ave, Valdosta, GA 31602 | 2008-08-19 |
| 1770703720 | Meredith Spann Barker | Dentist | 2311 N Patterson St, Valdosta, GA 31602-2510 | 2007-05-01 |
| 1285758086 | Ronald Kelley Reagin Jr. | Dentist | 2309 N Patterson St, Valdosta, GA 31602-2510 | 2007-03-19 |
| 1932239225 | Lisa Michelle Chatman | Dentist | 4258 Spring Branch Cir, Valdosta, GA 31601-0605 | 2007-03-06 |
| 1356486575 | Mark Allen Retterbush | Dentist | 2311 North Patterson St, Valdosta, GA 31602 | 2007-02-21 |
| Find all providers in VALDOSTA | ||||
Please comment or provide details below to improve the information on JAMES CHARLES BROADFOOT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.