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BROADWAY DENTAL PSC
NPI 1639222466
Dentist in Louisville, KY

Active since January 18, 2007
1813 WEST BROADWAY, LOUISVILLE, KY 40203(502) 772-7531 Get Directions Write a Review

NPPES record last updated: December 18, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Broadway Dental Psc NPPES

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

BROADWAY DENTAL PSC (NPI 1639222466) is a healthcare organization registered as a dentist in Louisville, Kentucky and active in the NPI registry since January 2007. The organization lists Rodney Brent Fultz, Sec Treasurer, as its authorized official.

NPPES Registry Identity

NPI1639222466
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameBROADWAY DENTAL PSC
Location Address1813 WEST BROADWAYLouisville, KY 40203
Mailing Address1813 West BroadwayLouisville, KY 40203 · (502) 772-7531
Phone(502) 772-7531
Organization SubpartNo
Authorized OfficialRodney Brent FultzSec Treasurer · (502) 772-7531
Enumeration DateJanuary 18, 2007
Last NPPES UpdateDecember 18, 2007
✔ NPI 1639222466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
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.
1813 WEST BROADWAY, Louisville, KY 40203
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Other Identifiers 1

Medicaid61941878KY

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

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

DR. RODNEY BRENT FULTZ DMD DENTIST
Dentist (General Practice)
1813 WEST BROADWAY
LOUISVILLE, KY 40203
Jefferson County (502) 772-7531

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 Psc's NPI number?

The NPI number for Broadway Dental Psc is 1639222466. It was assigned to this organization in the NPPES registry on January 18, 2007.

Where is Broadway Dental Psc located?

Broadway Dental Psc is located at 1813 West Broadway, Louisville, KY 40203. The listed phone number is (502) 772-7531.

What is Broadway Dental Psc's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Broadway Dental Psc was last updated on December 18, 2007. 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.