OrganizationActive
Broadway Dentist LLC
NPI 1235381302 · Dental Clinic/Center · Everett, MA
Provider details
- NPI number
- 1235381302
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Peter Itkes, Manager(617) 694-1614
- License
- 21366 (MA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(86/100 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
609 Broadway
Everett, MA 02149-3712
Phone: (617) 389-3636
Street-level locationGet directions
Mailing address
609 Broadway
Everett, MA 02149-3712
Registry dates
- Enumerated
- 2008-10-21
- Last updated
- 2008-10-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.