{
"Npi": {
"NPI": "1497344832",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DENTAL ARTS OF DOWNINGTOWN",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "104 SCHUBERT DR STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DOWNINGTOWN",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19335-3382",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "610-269-3978",
"MailingAddressFaxNumber": "610-269-9670",
"FirstLinePracticeLocationAddress": "104 SCHUBERT DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DOWNINGTOWN",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19335-3382",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "610-269-3978",
"PracticeLocationAddressFaxNumber": "610-269-9670",
"EnumerationDate": "01/11/2021",
"LastUpdateDate": "01/13/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRODERICK",
"AuthorizedOfficialFirstName": "CARRIEANN",
"AuthorizedOfficialMiddleName": "REWKOWSKI",
"AuthorizedOfficialTitle": "OWNER/DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "610-269-3978",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}