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DERRICK M. BROADAWAY, D.D.S., PC
NPI 1316156102
Dentist - General Practice in Virginia Beach, VA

Active since May 21, 2007
3809 PRINCESS ANNE RD, SUITE 111, VIRGINIA BEACH, VA 23456(757) 471-6672 Get Directions Write a Review

NPPES record last updated: April 7, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Derrick M. Broadaway, D.d.s., Pc NPPES

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

DERRICK M. BROADAWAY, D.D.S., PC (NPI 1316156102) is a healthcare organization registered as a general practice in Virginia Beach, Virginia and active in the NPI registry since May 2007. The organization lists Joyce S Davis, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1316156102
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameDERRICK M. BROADAWAY, D.D.S., PC
Location Address3809 PRINCESS ANNE RD, SUITE 111Virginia Beach, VA 23456-1900
Mailing Address3809 Princess Anne Rd, Suite 111Virginia Beach, VA 23456-1900 · (757) 471-6672
Phone(757) 471-6672
Organization SubpartYes
Authorized OfficialJoyce S DavisOffice Manager · (757) 471-6672
Enumeration DateMay 21, 2007
Last NPPES UpdateApril 7, 2008
✔ NPI 1316156102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
3809 PRINCESS ANNE RD, Virginia Beach, VA 23456
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Other Identifiers 5

Other000000005259VA · Dental Benefits Provider#
Other219275VA · Blue Cross Provider #
Other000000005259VA · United Healthcare Provide
Other619881VA · United Concordia Provider
Medicaid106546VA

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 6

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

DR. MARK JAMES WUCHNER D.D.S.
Dentist
3809 PRINCESS ANNE RD, SUITE 111
VIRGINIA BEACH, VA 23456
Virginia Beach City (757) 471-6672
BACK N SHAPE SPORTSMED
Chiropractor
3809 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23456
Virginia Beach City (757) 471-2800
JOSEPH MARCIL
Chiropractor
3809 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23456
Virginia Beach City (757) 471-2800
LAWRENCE I. IWUAMADI
Durable Medical Equipment & Medical Supplies
3809 PRINCESS ANNE RD, SUITE 108
VIRGINIA BEACH, VA 23456
Virginia Beach City (757) 470-5661
AMERICARE MEDICAL SUPPLIES & SERVICES INC
Durable Medical Equipment & Medical Supplies
3809 PRINCESS ANNE RD, SUITE 108
VIRGINIA BEACH, VA 23456
Virginia Beach City (757) 470-5661
JEFFREY SPAULDING DC
Chiropractor
3809 PRINCESS ANNE RD
VIRGINIA BEACH, VA 23456
Virginia Beach City (757) 471-2800

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 Derrick M. Broadaway, D.D.S., PC's NPI number?

The NPI number for Derrick M. Broadaway, D.D.S., PC is 1316156102. It was assigned to this organization in the NPPES registry on May 21, 2007.

Where is Derrick M. Broadaway, D.D.S., PC located?

Derrick M. Broadaway, D.D.S., PC is located at 3809 Princess Anne Rd Suite 111, Virginia Beach, VA 23456. The listed phone number is (757) 471-6672.

What is Derrick M. Broadaway, D.D.S., PC'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 Derrick M. Broadaway, D.D.S., PC was last updated on April 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.