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BROADWAY DENTAL LLC
NPI 1790816817
Dentist - General Practice in Denison, IA

Active since March 08, 2007
1415 BROADWAY, DENISON, IA 51442(712) 263-5615(712) 263-8124 Get Directions Write a Review

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 4, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Broadway Dental Llc NPPES

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

BROADWAY DENTAL LLC (NPI 1790816817) is a healthcare organization registered as a general practice in Denison, Iowa and active in the NPI registry since March 2007. The organization lists Kristi Ouderkirk-bock, Owner, as its authorized official.

NPPES Registry Identity

NPI1790816817
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBROADWAY DENTAL LLC
Location Address1415 BROADWAYDenison, IA 51442-2052
Mailing Address1415 BroadwayDenison, IA 51442-2052 · (712) 263-5615 · Fax (712) 263-8124
Phone(712) 263-5615
Fax(712) 263-8124
Organization SubpartNo
Authorized OfficialKristi Ouderkirk-bockOwner · (712) 263-5615
Enumeration DateMarch 8, 2007
Last NPPES UpdateApril 4, 20252 updates tracked since enumeration
NPPES CertifiedApril 4, 2025
✔ NPI 1790816817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IA · 07912
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.
1415 BROADWAY, Denison, IA 51442
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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.

DR. KRISTI ANN OUDERKIRK-BOCK DDS
Dentist (General Practice)
1415 BROADWAY
DENISON, IA 51442
Crawford County (712) 263-5615
DR. DOUGLASS J SOSEMAN DDS
Dentist (General Practice)
1415 BROADWAY
DENISON, IA 51442
Crawford County (712) 263-5615
JESSICA CERVANTES MARTENS DDS
Dentist (General Practice)
1415 BROADWAY
DENISON, IA 51442
Crawford County (712) 263-5615

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 LLC's NPI number?

The NPI number for Broadway Dental LLC is 1790816817. It was assigned to this organization in the NPPES registry on March 8, 2007.

Where is Broadway Dental LLC located?

Broadway Dental LLC is located at 1415 Broadway, Denison, IA 51442. The listed phone number is (712) 263-5615.

What is Broadway Dental LLC'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 LLC was last updated on April 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.