Family Dentistry SC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FAMILY DENTISTRY SC

Practice address

205 S Division St
Roberts, WI 54023

Phone

(715) 749-3724

Fax

(715) 246-6649

NPI assigned

Apr 29, 2008

Last updated

Apr 29, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kellie D Lindquist, DDS

Title

Dentist

Phone

(715) 749-3724

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Family Dentistry SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Family Dentistry SC

  • General Practice Dentistry
  • New Richmond, WI
  • NPI 1205915287
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1063687150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 118",
            "address_2": "205 S DIVISION ST",
            "city": "ROBERTS",
            "state": "WI",
            "postal_code": "54023",
            "telephone_number": "715-749-3724",
            "fax_number": "715-246-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S DIVISION ST",
            "city": "ROBERTS",
            "state": "WI",
            "postal_code": "54023",
            "telephone_number": "715-749-3724",
            "fax_number": "715-246-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "LINDQUIST",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "715-749-3724",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38371000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baldwin Area Medical Center, Inc. (Western Wisconsin Health)
• Baldwin Area Medical Center, Inc.
• Madeline Boe, M.S. CCC-SLP
• Cathy L Coghlan, OTR/L
• Dr.Mann Family Dental Care LLC
• Hudson Hospital Inc.
• Stephanie Larson, MSW, LICSW, LCSW
• Julie Ann Madaris
• Ajaypal Singh Mann
• Nan Reinhardt, Otr/L & Assoc, LLC

• General Practice Dentistry in Roberts, WI
• Providers in Roberts, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.