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BROADWAY DENTAL SERVICES
NPI 1215219084
Dentist - General Practice in Gary, IN

Active since September 16, 2011

NPPES record last updated: September 16, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Broadway Dental Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROADWAY DENTAL SERVICES (NPI 1215219084) is a healthcare organization registered as a general practice in Gary, Indiana and active in the NPI registry since September 2011. The organization lists Mukuka Kapilikisha, Owner, as its authorized official.

NPPES Registry Identity

NPI1215219084
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBROADWAY DENTAL SERVICES
Location Address3195 BROADWAYGary, IN 46409-1006
Mailing Address1693 Stillwater AveDyer, IN 46311-3088 · (219) 671-3754
Phone(219) 671-3754
Organization SubpartNo
Authorized OfficialMukuka KapilikishaOwner · (219) 671-3754
Enumeration DateSeptember 16, 2011
✔ NPI 1215219084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IN · 12011216A
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
3195 BROADWAY, Gary, IN 46409
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EDWIN KENNETH MCDONALD III DDS
Dentist
3195 BROADWAY
GARY, IN 46409
Lake County (219) 887-0104
BROADWAY MEDICAL CORPORATION, PC
Specialist
3195 BROADWAY
GARY, IN 46409
Lake County (219) 887-0900
ADOLPHUS A ANEKWE M.D.
Specialist
3195 BROADWAY
GARY, IN 46409
Lake County (219) 887-0900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broadway Dental Services's NPI number?

The NPI number for Broadway Dental Services is 1215219084. It was assigned to this organization in the NPPES registry on September 16, 2011.

Where is Broadway Dental Services located?

Broadway Dental Services is located at 3195 Broadway, Gary, IN 46409. The listed phone number is (219) 671-3754.

What is Broadway Dental Services's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Broadway Dental Services was last updated on September 16, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.