Algoma Fama Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ALGOMA FAMA DENTAL LLC

Doing business as

Algoma Family Dentistry

Practice address

1421 Lake St
Algoma, WI 54201-1449

Phone

(920) 487-2733

NPI assigned

Aug 19, 2024

Last updated

Aug 19, 2024By 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. Daniel Fama, DDSNPI 1629695051

Title

Owner/Dentist

Phone

(585) 705-5750

Specialties & licenses 1

Addresses

Other names 1

• Algoma Family Dentistry Doing business as

Locations

Practitioners 2

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.

• Daniel Fama, DDS

  • General Practice Dentistry
  • Shoreview, MN
  • NPI 1629695051
  NPD Authorized official
• Sean M McLuen, DDS

  • General Practice Dentistry
  • Menasha, WI
  • NPI 1851612899
  NPD (past)

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1205668043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 LAKE ST",
            "city": "ALGOMA",
            "state": "WI",
            "postal_code": "542011449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 LAKE ST",
            "city": "ALGOMA",
            "state": "WI",
            "postal_code": "542011449",
            "telephone_number": "920-487-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALGOMA FAMA DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "FAMA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "585-705-5750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Algoma Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Algoma Health Opco LLC
• Algoma Hometown Pharmacy LLC
• Algoma Lakeview Dental Care, S.C.
• Algoma Medical Center (Algoma Medical Center & LTC)
• Aurora Pharmacy Inc (Aurora Pharmacy)

• Dental Clinic/Center in Algoma, WI
• Providers in Algoma, 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 Aug 19, 2024; 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.