NPIMap

Organization Active NPI

Hayward Family Dentistry SC

  • Dentist
  • Hayward, WI
National Provider Identifier
1083716906
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3762 Issued in WI
Legal business name
HAYWARD FAMILY DENTISTRY SC
Practice address
10541 N Ranch Rd
Hayward, WI 54843
Phone
(715) 634-2011
Fax
(715) 634-1352
NPI assigned
Sep 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Authorized official

Name
Dr. Patrick T Duffy, DDSNPI 1023265592
Title
Owner
Phone
(715) 634-2011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 3762 WI Primary

Addresses

Primary practice location

10541 N Ranch Rd
Hayward, WI 54843

Mailing address

PO Box 1220
Hayward, WI 54843
Phone (715) 634-2011

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1083716906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1220",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "54843",
            "telephone_number": "715-634-2011",
            "fax_number": "715-634-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10541 N RANCH RD",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "54843",
            "telephone_number": "715-634-2011",
            "fax_number": "715-634-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYWARD FAMILY DENTISTRY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "DUFFY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-634-2011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "3762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.