BROADWAY SMILES (NPI# 1427417328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427417328 |
| Entity Type | Organization |
| Organization Name | BROADWAY SMILES |
| Other Organization Name | BROADWAY SMILES |
| Practice Address |
126 W El Norte Pkwy Escondido CA 92026-2502 |
| Practice Telephone | 7604805622 |
| Practice Fax Number | 7604805623 |
| Mailing Telephone | 7604805622 |
| Mailing Fax Number | 7604805623 |
| Enumeration Date | 2016-02-19 |
| Last Update Date | 2016-02-19 |
| Authorized Official Name | MARLENE THOMPSON (OWNER) |
| Authorized Official Telephone | 7604805622 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | NC FAMILY DENTAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 50382 | CA | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| Broadway Smiles | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275999872 | Broadway Smiles | Clinic/Center | 505 1st St Ste B, Idaho Falls, ID 83401-3929 | 2016-01-12 |
| 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 |
126 W EL NORTE PKWY |
| City | ESCONDIDO |
| State | CA |
| Zip Code | 92026-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174626113 | Ada Zaw | Dentist | 126 W El Norte Pkwy, Escondido, CA 92026-2502 | 2006-09-06 |
| 1538342258 | Zaw Professional Dental, Corp. | Clinic/Center | 126 W El Norte Pkwy, Escondido, CA 92026-2502 | 2007-12-17 |
| 1316064280 | Timothy Zaw | Dentist | 126 W El Norte Pkwy, Escondido, CA 92026-2502 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477908663 | Nancy Martinez-molano | Counselor | 1029 N. Broadway Avenue, Escondido, CA 92026 | 2016-04-26 |
| 1114322765 | Christina Boekamp | Speech-Language Pathologist | 1325 Las Villas Way, Escondido, CA 92026 | 2014-10-24 |
| 1609170356 | Pectus Services of Southern California LLC | Durable Medical Equipment & Medical Supplies | 317 N. Elcamino Real, Suite 502, Encinitas, CA 92026 | 2011-01-10 |
| 1518277987 | Maryam Delsen | Social Worker | 1029 N. Broadway Ave., Escondido, CA 92026 | 2010-10-19 |
| 1528372554 | Shirley Dianne Kunkel | Speech-Language Pathologist | 9649 Galatea Lane, Escondido, CA 92026 | 2010-08-02 |
| 1124295266 | Kendell Hales Ricks | Dentist | 8895 Lawrence Welk Dr, Escondido, CA 92026 | 2008-05-08 |
| 1861517005 | Mountain Shadows Support Group, Inc | Nursing Facility/Intermediate Care Facility | 4840 Fairhill Place, Riverside, CA 92026 | 2007-03-20 |
| 1982731253 | Cynthia Louise Canney | Marriage & Family Therapist | 502 W. El Norte Parkway, Excondido, CA 92026 | 2007-02-27 |
| 1992891790 | Vijaya Kv Prabhu | Dentist | El Norte Family Dental., 306 W.el Norte Pkwy. Suite D & E, Escondido, CA 92026 | 2006-10-05 |
| 1174065403 | Rashida Black | Counselor | 1341 N Escondido Blvd, Escondido, CA 92026 | 2016-11-17 |
| Find all providers in zip 92026 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730291832 | Beatriz Vidales Dds, Inc | Preferred Provider Organization | 725 N Quince St, 101, Escondido, CA 92025-1680 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154961142 | Hoag Physcian Partners | Preferred Provider Organization | 16148 Sand Canyon Ave Fl 2, Irvine, CA 92618-3700 | 2020-01-08 |
| 1356806525 | Premierone Plus Aco | Preferred Provider Organization | 1210 N Jefferson St Ste D, Anaheim, CA 92807-1630 | 2019-02-01 |
| 1548730450 | Mastour & Fard Dental Corp | Preferred Provider Organization | 587 N. Ventu Park Road., Suite C, Newberry Park, CA 91320 | 2018-12-04 |
| 1689151698 | David W Schwartz Md A Medical Corporation | Preferred Provider Organization | 29645 Rancho California Rd Ste 105, Temecula, CA 92591 | 2018-07-23 |
| 1184100471 | Care Allies Ipa, Inc | Preferred Provider Organization | 1211 W La Palma Ave Ste 309, Anaheim, CA 92801-2811 | 2018-07-19 |
| 1245723071 | Pacific Associates Medical Group, Inc. | Preferred Provider Organization | 9900 Lakewood Blvd Ste 103, Downey, CA 90240-4039 | 2018-06-06 |
| 1821585266 | Anthony Nguyen Dds Inc | Preferred Provider Organization | 1125 E 17th St Ste N156, Santa Ana, CA 92701-2215 | 2018-04-20 |
| 1275038051 | Ryan Lange D.m.d. Inc. | Preferred Provider Organization | 17897 Macarthur Blvd Ste 100, Irvine, CA 92614-0532 | 2018-03-26 |
| 1649798190 | Freedom Physicians Corporation | Preferred Provider Organization | 2295 Huntington Dr., Ste. D, San Marino, CA 91108 | 2017-09-05 |
| 1952835282 | Dr. Jose Flores D.d.s Inc. | Preferred Provider Organization | 11510 Downey Ave, Downey, CA 90241 | 2017-04-13 |
| Find all providers with the same taxonomy | ||||
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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.