Kaukauna Family Dentistry, S.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5001987-015 Issued in WI

Legal business name

KAUKAUNA FAMILY DENTISTRY, S.C.

Practice address

233 Dodge St
Kaukauna, WI 54130-2500

Phone

(920) 766-9542

Fax

(920) 759-4439

NPI assigned

Sep 27, 2006

Last updated

Jun 21, 2018By 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

Dr. William J. Farrow, D.D.S.NPI 1508957523

Title

Owner/President

Phone

(920) 766-9542

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William J. Farrow, D.D.S.

  • General Practice Dentistry
  • Kaukauna, WI
  • NPI 1508957523
  NPD (past) Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1073604013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 DODGE ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541302500",
            "telephone_number": "920-766-9542",
            "fax_number": "920-759-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 DODGE ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541302500",
            "telephone_number": "920-766-9542",
            "fax_number": "920-759-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAUKAUNA FAMILY DENTISTRY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "FARROW",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "920-766-9542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001987-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38377600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katy A Kaminski, MT
• Nicole Kappell, LMT
• Sydney Kappus
• Kaukauna Area School District
• Kaukauna Clinic, S.C.
• Kaukauna Prescription Center (Consumer Prescription Center)
• Michael Kilgas, DPT
• Lori Deprez King, RN, APNP
• Jennifer Lynn Kitelinger, OTR
• Michele Knapp-Pingel, PTA

• General Practice Dentistry in Kaukauna, WI
• Providers in Kaukauna, 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 Jun 21, 2018; 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.