DR. JEFFREY P BROADBENT (NPI# 1336434661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336434661 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY P BROADBENT |
| Credential | DMD |
| Practice Address |
3590 Harrison Blvd Suite 5 Ogden UT 84403-2060 |
| Mailing Address |
College Park Plaza Harrison 3590 Suite 5 Ogden UT 84403 |
| Practice Telephone | 8016211440 |
| Practice Fax Number | 8013946833 |
| Mailing Telephone | 8016211440 |
| Mailing Fax Number | 8013946833 |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2011-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 5329002-9922 | UT | Dental Providers |
| Street Address |
3590 HARRISON BLVD SUITE 5 |
| City | OGDEN |
| State | UT |
| Zip Code | 84403-2060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093791311 | Chantel B Murrah | Podiatrist | 3590 Harrison Blvd, # G1, Ogden, UT 84403-2060 | 2005-12-19 |
| 1316360522 | Chantel B. Murrah, Dpm. Phd | Podiatrist | 3590 Harrison Blvd, #g1, Ogden, UT 84403-2060 | 2014-01-23 |
| 1437401932 | Steven Jones Wideman | Podiatrist | 3590 Harrison Blvd, #g-1, Ogden, UT 84403-2060 | 2012-10-08 |
| 1760664668 | Dr Lorell Fawson Dpm | Podiatrist | 3590 Harrison Blvd, Suite G1, Ogden, UT 84403-2060 | 2007-12-03 |
| 1427262666 | John Robert Starley | Dentist | 3590 Harrison Blvd, #6, Ogden, UT 84403-2060 | 2007-05-09 |
| 1205049459 | Michael William Broadbent | Dentist | 3590 Harrison Blvd, Suite #2, Ogden, UT 84403-2060 | 2007-05-07 |
| 1235341744 | Lloyd V. Tilt, Dds,ms,pc | Clinic/Center | 3590 Harrison Blvd, Ste 3, Ogden, UT 84403-2403 | 2007-05-04 |
| 1538204318 | David O Hendrickson | Dentist | 3590 Harrison Blvd, Suite 1, Ogden, UT 84403-2060 | 2007-02-20 |
| 1265582696 | Aaron Ward | Dentist | 3590 Harrison Blvd, Suite 3, Ogden, UT 84403-2060 | 2007-01-10 |
| 1144200155 | Lorell B Fawson | Podiatrist | 3590 Harrison Blvd, G1, Ogden, UT 84403 | 2006-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
| 1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
| 1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
| 1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
| 1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
| 1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
| 1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
| 1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
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| 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 |
|---|---|---|---|---|
| 1710415245 | Joshua Jay Matthews | Dentist | 3636 Saddle Horn Trl, Ogden, KS 66517-4002 | 2017-05-29 |
| 1306391180 | Affleck Restorative & Prosthetic Dentistry | Dentist | 2537 N Washington Blvd, Ogden, UT 84414-7244 | 2016-08-22 |
| 1598128084 | Brett Ballingham | Dentist | 285 W 5600 S, Ogden, UT 84405-6867 | 2016-04-01 |
| 1770923328 | Garrett John Frost | Dentist | 1186 E 4600 S Ste 410, Ogden, UT 84403-4895 | 2013-06-27 |
| 1396032041 | Kiley Boss | Dentist | 1508 E Skyline Dr Ste 400, Ogden, UT 84405-4856 | 2011-07-01 |
| 1497065551 | John Armstrong Green | Dentist | 5029 S 1200 E, Ogden, UT 84403-4297 | 2010-10-07 |
| 1306095179 | Thomas Matthews | Dentist | 2711 N Hwy 89, Ste 100, Ogden, UT 84404-1205 | 2008-09-16 |
| 1326201765 | Kelly C Wilkins Jr. | Dentist | 2274 North 400 East, Suite 204, Ogden, UT 84414-7241 | 2008-07-07 |
| 1174791891 | Ronald Thane Hales | Dentist | 945 E 5000 S, Ogden, UT 84403-3919 | 2008-02-15 |
| 1023150679 | Bart Wilson Wolthuis | Dentist | 512 12th Street, Ogden, UT 84404 | 2007-02-12 |
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| 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.