Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1013455492 Individual Practitioner Male Practitioner

Landen Broadhead

Dentist • Travis Afb, CA

Professional Overview & Biography Verified Profile Summary

Landen Broadhead is a registered healthcare professional specializing in Dentist in Travis Afb, CA. Practice services are available at 151 BODIN CIR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

151 Bodin Cir

Travis Afb, CA 945351801

Telephone 7074237000

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Travis Afb, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
20 Specialists

Practicing in Travis Afb, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-07-25
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License UT 13972455-9926

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Counselor

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

19 Associated Practitioners
Dr. Paulencia Morris , DDS

Dentist - Pediatric Dentistry

NPI 1073789707

Doctor of Dental Surgery

Dr. Austin Wood , DDS

Dentist - General Practice

NPI 1134064074

Doctor of Dental Surgery

Dr. Son Vu , DDS

Dentist - General Practice

NPI 1134110877

Doctor of Dental Surgery

David Welch

Dentist - Pediatric Dentistry

NPI 1134487085
Amy Park

Dentist

NPI 1164360996
Dr. Renee Smith , DDS, MS

Dentist - Endodontics

NPI 1164911053

Doctor of Dental Surgery, Master of Science

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location July 25, 2024

Registered at 151 BODIN CIR, TRAVIS AFB, CA 945351801 (Tel: 7074237000)

📍
Updated Business Mailing Address May 23, 2024

Registered at 101 BODIN CIR BLDG 777, TRAVIS AFB, CA 945351809

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 23, 2024

Dentist (License #13972455-9926 in UT)

NPI Profile Active February 06, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location February 06, 2017

Registered at 6013 S REDWOOD RD, TAYLORSVILLE, UT 841235220 (Tel: 8012555131)

📍
Updated Business Mailing Address February 06, 2017

Registered at 6013 S REDWOOD RD, TAYLORSVILLE, UT 841235220 (Tel: 8012555131)

👤
Provider Name / Credentials Updated February 06, 2017

Recorded as LANDEN BROADHEAD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 06, 2017

Counselor

🟢
Initial NPI Registration & Enumeration February 06, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1013455492
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 06, 2017
Last Update: July 25, 2024
Sole Proprietor: Yes

Mailing Address

101 Bodin Cir Bldg 777

Travis Afb, CA 945351809

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.