Organization Active NPI

Nakoma Dental LLC

  • General Practice Dentistry
  • Madison, WI
National Provider Identifier
1083778799
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NAKOMA DENTAL LLC
Practice address
4333 Nakoma Road
Madison, WI 53711
Phone
(608) 271-0331
Fax
(608) 271-3464
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Donald W Tipple, DDSNPI 1467487934
Title
Owner Doctor
Phone
(608) 271-0331

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
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X WI Primary

Addresses

Primary practice location

4333 Nakoma Road
Madison, WI 53711

Mailing address

4333 Nakoma Road
Madison, WI 53711
Phone (608) 271-0331

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": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083778799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 NAKOMA ROAD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53711",
            "telephone_number": "608-271-0331",
            "fax_number": "608-271-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4333 NAKOMA ROAD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53711",
            "telephone_number": "608-271-0331",
            "fax_number": "608-271-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAKOMA DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TIPPLE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "608-271-0331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.