BROADWAY SMILES (NPI# 1275999872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275999872 |
| Entity Type | Organization |
| Organization Name | BROADWAY SMILES |
| Other Organization Name | SIGNATURE SMILES |
| Practice Address |
505 1st St Ste B Idaho Falls ID 83401-3929 |
| Practice Telephone | 2085291903 |
| Practice Fax Number | 2085291925 |
| Mailing Telephone | 2085291903 |
| Mailing Fax Number | 2085291925 |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |
| Authorized Official Name | NATALY PENUELAS (OFFICE MANAGER) |
| Authorized Official Telephone | 2086800186 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D-4109 | ID | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Signature Smiles | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427417328 | Broadway Smiles | Preferred Provider Organization | 126 W El Norte Pkwy, Escondido, CA 92026-2502 | 2016-02-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | BROADWAY SMILES DENTAL CLINIC INCORPORATED | 144 Broadway, Revere, MA 02151 |
| New York State Corporations | BROADWAY SMILES DENTAL, P.C. | 3 Vandalay Court, Scarsdale, New York 10583 |
| Street Address |
505 1ST ST STE B |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83401-3929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454796 | Natalie M Theriault | Acupuncturist | 864 S Holmes, Idaho Falls, ID 83401 | 2020-10-09 |
| 1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
| 1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
| 1467924985 | Benchmark Home Health | Registered Nurse | 2098 Gladys Dr., Idaho Falls, ID 83401 | 2018-12-21 |
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 1992227367 | Brenda Emery | Rehabilitation Practitioner | 540 3rd Street, Idaho Falls, ID 83401 | 2017-07-07 |
| 1689068454 | Addiction Treatment Centers of Idaho | Community/Behavioral Health | 211 S. Woodruff Avenue, Idaho Falls, ID 83401 | 2015-03-19 |
| 1386986412 | Jennifer Lee Henderson | Psychologist | 111 E. 16th Street, Innovative Health Care Concepts Inc., Idaho Falls, ID 83401 | 2013-03-27 |
| 1487994430 | Sterling Physician Group Pllc | Clinic/Center | 740 S. Woodruff Ave, Idaho Falls, ID 83401 | 2013-02-27 |
| 1952638025 | Allstar Counseling Inc. | Case Management | 550 2nd Street, Suite 269, Idaho Falls, ID 83401 | 2009-11-11 |
| Find all providers in zip 83401 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659748903 | Boyle Family Dental | Clinic/Center | 1370 E 17th St, Idaho Falls, ID 83404-6270 | 2015-08-21 |
| 1780819516 | Willow Creek Dental PC | Clinic/Center | 1380 Latah Ave, Idaho Falls, ID 83402 | 2009-05-22 |
| 1346702461 | Brent Cline Dds Pllc | Clinic/Center | 749 Oxford Dr, Idaho Falls, ID 83401-4203 | 2019-04-05 |
| 1407355092 | Zimbi Dental Pllc | Clinic/Center | 1400 E 17th St, Idaho Falls, ID 83404-6269 | 2018-02-08 |
| 1508378647 | Bird Family Dental Idaho Falls, Pllc | Clinic/Center | 2960 Cortez Ave, Idaho Falls, ID 83404-7554 | 2017-10-30 |
| 1538596424 | Couch Dental Care | Clinic/Center | 2110 E 25th St, Idaho Falls, ID 83404-6475 | 2013-10-09 |
| 1669771069 | Atwood Family Dentistry | Clinic/Center | 1759 W Broadway St, Idaho Falls, ID 83402-3045 | 2011-03-24 |
| 1780904623 | Hoover Chartered | Clinic/Center | 1520 Elk Creek Dr, Idaho Falls, ID 83404-8322 | 2010-06-02 |
| 1679704647 | Comfort Care Dental of Idaho Falls, Pllc | Clinic/Center | 3550 Washington Pkwy, Idaho Falls, ID 83404-4968 | 2009-08-07 |
| 1104085935 | Moulton Periodontics, Pllc | Clinic/Center | 2375 E Sunnyside Rd, Suite I, Idaho Falls, ID 83404-8280 | 2008-06-06 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83401 |
Please comment or provide details below to improve the information on BROADWAY SMILES.
| 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.