New London Family Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NEW LONDON FAMILY DENTAL LLC

Practice address

105 North Ridge Dr
New London, WI 54961-5496

Phone

(920) 982-3567

NPI assigned

Nov 15, 2018

Organization subpart

No

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

Authorized official

Name

Kayla Thorpe

Title

Office Manager

Phone

(920) 982-3567

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1154890549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 NORTHRIDGE DR",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612703",
            "telephone_number": "920-982-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 NORTH RIDGE DR",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549615496",
            "telephone_number": "920-982-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LONDON FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-15",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "THORPE",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "920-982-3567"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Martzahl, COTA
• Manuel A Mendoza, MD
• Samantha A Metko, RDN, IBCLC
• Nina M. Minnear, PT
• Robert Michael Minturn, PT, DPT
• New London Family Medical Center Inc
• Grace Elizabeth Nigl
• Herbert A Nolan, APNP
• North Eastern Wisconsin Rehabilitation Corporation
• Marsha Ann Nytes, LPN

• Dental Clinic/Center in New London, WI
• Providers in New London, WI by specialty
• Dental Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.