Provider Demographics
NPI:1902008584
Name:BRODY, JOSEPH JOSHUA (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOSHUA
Last Name:BRODY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 PLAINSBORO RD
Mailing Address - Street 2:BLDG 100 SUITE 1G
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-3030
Mailing Address - Country:US
Mailing Address - Phone:609-799-9100
Mailing Address - Fax:609-799-9104
Practice Address - Street 1:666 PLAINSBORO RD
Practice Address - Street 2:BLDG 100 SUITE 1G
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-3030
Practice Address - Country:US
Practice Address - Phone:609-799-9100
Practice Address - Fax:609-799-9104
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11112122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist