1. Home
  2. Directory
  3. Rhode Island
  4. Providence
  5. Dentist
  6. NPI Profile

DR. JOHN G. BRODERICK DMD
NPI 1841403953
Dentist - Periodontics in Providence, RI

Active since May 07, 2007
167 GANO ST, PROVIDENCE, RI 02906(401) 274-2600(401) 421-7875 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. John G. Broderick Dmd NPPES

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

DR. JOHN G. BRODERICK DMD (NPI 1841403953) is an individual periodontics provider in Providence, Rhode Island, licensed in Rhode Island (DEN02700) and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1841403953
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. JOHN G. BRODERICKCredential: DMD
Location Address167 GANO STProvidence, RI 02906-3808
Mailing Address200 Heroux Blvd Unit 507Cumberland, RI 02864-2384 · (401) 954-7760 · Fax (401) 421-7875
Phone(401) 274-2600
Fax(401) 421-7875
Sole ProprietorNo
Enumeration DateMay 7, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1841403953 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in RI · DEN02700
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
167 GANO ST, Providence, RI 02906
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Other Providers at the Same Location NPPES 4

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

SILK PHYSICAL THERAPY CENTER, INC.
Clinic/Center (Physical Therapy)
167 GANO ST
PROVIDENCE, RI 02906
Providence County (401) 274-4325
MR. ALAN NEIL SILK P.T.
Physical Therapist
167 GANO ST, LOWER LEVEL
PROVIDENCE, RI 02906
Providence County (401) 274-4325
ERICA KLEINBAUM DMD
Dentist (Periodontics)
167 GANO ST
PROVIDENCE, RI 02906
Providence County (401) 274-2600
DR. SCOTT MARK FERTIK DDS
Dentist (Periodontics)
167 GANO ST
PROVIDENCE, RI 02906
Providence County (401) 274-2600

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 John Broderick's NPI number?

The NPI number for John Broderick is 1841403953. It was assigned to this individual provider in the NPPES registry on May 7, 2007.

Where is John Broderick located?

John Broderick practices at 167 Gano St, Providence, RI 02906. The listed phone number is (401) 274-2600.

What is John Broderick's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

What insurance does John Broderick accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list John Broderick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for John Broderick was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.