OrganizationActive
Broad Park Dental PA
NPI 1083849707 · General Practice Dentistry · Mansfield, TX
Provider details
- NPI number
- 1083849707
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Jeremy Rudd, Owner(817) 473-6857
- License
- 22486 (TX)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1750 E Broad St
Mansfield, TX 76063-3400
Phone: (817) 473-6857
Fax: (817) 473-3256
Street-level locationGet directions
Mailing address
1750 E Broad St
Mansfield, TX 76063-3400
Registry dates
- Enumerated
- 2009-05-26
- Last updated
- 2009-05-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.