PAUL M BROADWATER (NPI# 1750435020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750435020 |
| Entity Type | Individual |
| Full Name | PAUL M BROADWATER |
| Credential | D.D.S. |
| Practice Address |
2080 Murray Holladay Rd Salt Lake City UT 84117-5132 |
| Practice Telephone | 8012787272 |
| Practice Fax Number | 8012783108 |
| Mailing Telephone | 8012787272 |
| Mailing Fax Number | 8012783108 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
1424299922 | UT | Dental Providers |
| Street Address |
2080 MURRAY HOLLADAY RD |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84117-5132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063052256 | Abundant Dental Care, P.C. | Dentist | 1548 E 4500 S #104, Holladay, UT 84117 | 2020-01-15 |
| 1578127221 | Signature Utah Dental Partners PC | Clinic/Center | 2240 E Murray Holladay Rd, Holladay, UT 84117 | 2019-04-29 |
| 1700392974 | Marette Monson, LLC | Community/Behavioral Health | 2180 East 4500 South, Suite 105, Holladay City, UT 84117 | 2017-12-23 |
| 1942714639 | Harmon City Inc | Pharmacy | 4675 South Holladay Blvd, Holladay, UT 84117 | 2017-11-17 |
| 1881119444 | Brianna Stewart | Physical Medicine & Rehabilitation | 5151 South 900 East, Suite 100, Salt Lake City, UT 84117 | 2017-08-04 |
| 1861842874 | Whitney Aste | Dentist | 1548 E 4500 S Ste 104, Salt Lake City, UT 84117 | 2016-06-21 |
| 1922403765 | Tri-peak, Pllc | Psychologist | 4535 S 2300 E, Suite B, Salt Lake City, UT 84117 | 2014-10-22 |
| 1356689566 | Mckenzie Vierig | Marriage & Family Therapist | 4568 S Highland Dr Ste 380, Millcreek, UT 84117 | 2013-01-22 |
| 1821348640 | Fabiola Marquez Jamieson | Social Worker | 4500 S 2180 E, Suite 165, Holladay, UT 84117 | 2012-09-19 |
| 1073882882 | Amy Rose White | Social Worker | 4500 South 2180 East, Suite 165, Holladay, UT 84117 | 2011-12-22 |
| Find all providers in zip 84117 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285086355 | Morrison Orthodontics, Pllc | Dentist | 2080 E Murray Holladay Rd, Salt Lake City, UT 84117-5132 | 2016-07-12 |
| 1659591238 | Mark J Mcdonough | Dentist | 6070 South 1300 East, Suite 202, Salt Lake City, UT 84121-6724 | 2007-04-26 |
| 1568681450 | S Donald Gardner | Dentist | 7138 Highland Dr Ste 213, Salt Lake City, UT 84121-3781 | 2007-04-25 |
| 1669690236 | Norman A Maxfield | Dentist | 6243 S Redwood Rd Ste 240, Salt Lake City, UT 84123-6412 | 2007-04-20 |
| 1629295050 | David Vernon Young | Dentist | 622 E 4500 S Ste 202, Salt Lake City, UT 84107-2922 | 2007-04-19 |
| 1306968359 | John W Graham | Dentist | 705 E 900 S Ste 300, Salt Lake City, UT 84105-1281 | 2007-04-03 |
| 1801916309 | Feller Orthodontics A Professional Organization | Dentist | 2505 E 3300 S, Salt Lake City, UT 84109-2737 | 2007-03-29 |
| 1407913726 | Peter E Paulos | Dentist | 6287 S Redwood Rd Ste 202, Salt Lake City, UT 84123-6655 | 2007-01-03 |
| 1659431526 | Alan Charles Jensen | Dentist | 1377 East 3900 South, Suite 203, Salt Lake City, UT 84124 | 2006-12-11 |
| 1659446748 | Richard L Curtis Dds Ms PC | Dentist | 2025 S 1300 E, Suite 1, Salt Lake City, UT 84105-3698 | 2006-11-22 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84117 |
Please comment or provide details below to improve the information on PAUL M BROADWATER.
| 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.