Provider Demographics
NPI:1346572948
Name:JOEL F. BRODSKY DDS INC
Entity Type:Organization
Organization Name:JOEL F. BRODSKY DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:BRODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-496-2000
Mailing Address - Street 1:5920 DEL AMO BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90713-1949
Mailing Address - Country:US
Mailing Address - Phone:562-496-2000
Mailing Address - Fax:562-497-2064
Practice Address - Street 1:5920 DEL AMO BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90713-1949
Practice Address - Country:US
Practice Address - Phone:562-496-2000
Practice Address - Fax:562-497-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-06
Last Update Date:2010-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA242751223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty