NPI age
4 years
Enumerated 2022-03-04
● Active Type 2 · Organization
Broadway Pediatric Dentistry, Pllc
Broadway Pediatric Dentistry, Pllc is 1 of 1797 dentist organizations in Texas.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Ayala
Owner
Last NPPES update
2022-03-04
Source: monthly bulk 2026-05
How this organization compares
Across 1797 active dentist providers in Texas.
NPI age
4 years
↓ 10 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2022 → 2026
2022-03Enumerated in NPPES
2022
2026
Where they practice
Primary practice location
3006 Broadway Ste 103
San Antonio, TX 782091561
Mailing address
Po Box 356
Lytle, TX 780520356
Authorized official
Joanna Ayala
Owner
📞 1210632456
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Mauricio Marcushamer, DDS Dentist NPI 1699842690
Specialties
-
Dentist PrimaryAn age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.