Landen Broadhead, is a
Dentist based in Travis Afb, California. Landen Broadhead is licensed to practice in Utah (license number 13972455-9926) and his current practice location is
151 Bodin Cir, Travis Afb, California. He can be reached at his office (for appointments etc.) via phone at
(707) 423-7000.
NPI number for Landen Broadhead is 1013455492 and his current mailing address is 101 Bodin Cir Bldg 777, Travis Afb, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1013455492.
Healthcare Provider's Profile
| Full Name | Landen Broadhead |
|---|
| Gender | Male |
|---|
| Speciality | Dentist |
|---|
| Location | 151 Bodin Cir, Travis Afb, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1013455492
- Provider Enumeration Date: 02/06/2017
- Last Update Date: 07/25/2024
Medical Identifiers
Medical identifiers for Landen Broadhead such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013455492 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (NU) | Secondary |
| 122300000X | Dentist | 13972455-9926 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Landen Broadhead is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Landen Broadhead,
101 Bodin Cir Bldg 777,
Travis Afb, CA 94535-1809
Ph: Not Available | Landen Broadhead,
151 Bodin Cir,
Travis Afb, CA 94535-1801
Ph: (707) 423-7000 |
Reviews and Comments