NPIMap

Organization Active NPI

King Family Dentistry

  • General Practice Dentistry
  • Greenfield, WI
National Provider Identifier
1083929814
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5258-15 Issued in WI
Legal business name
KING FAMILY DENTISTRY
Practice address
6520 W Layton Ave
Greenfield, WI 53220-4500
Phone
(414) 282-5560
Fax
(414) 282-6790
NPI assigned
Aug 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Authorized official

Name
Ms. Lynette Marie Laur
Title
Office Manager
Phone
(414) 282-5560

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 5258-15 WI Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 5001352-12 WI

Addresses

Primary practice location

6520 W Layton Ave
Greenfield, WI 53220-4500

Mailing address

6520 W Layton Ave
Greenfield, WI 53220-4500
Phone (414) 282-5560

Other identifiers 2

IdentifierTypeStateIssuer
5001352-12OtherWIDENTIST
5258-15OtherWIDENTIST

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282003200000",
    "number": "1083929814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204500",
            "telephone_number": "414-282-5560",
            "fax_number": "414-282-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204500",
            "telephone_number": "414-282-5560",
            "fax_number": "414-282-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-17",
        "last_updated": "2010-08-17",
        "status": "A",
        "authorized_official_last_name": "LAUR",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "414-282-5560",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5258-15",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001352-12",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "5001352-12",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "5258-15",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; 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.