Individual provider Active NPI

Cailyn Lloyd, DDS

  • General Practice Dentistry
  • Fond Du Lac, WI
National Provider Identifier
1215948880
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
WI 2713 Issued in WI
Practice address
545 E Johnson St
Fond Du Lac, WI 54935-2856
Phone
(920) 924-9090
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X WI 2713 WI
General Practice Dentistry 1223G0001X WI 2713 WI Primary

Addresses

Primary practice location

545 E Johnson St
Fond Du Lac, WI 54935-2856

Mailing address

PO Box 190
717 S Water St
Lomira, WI 53048-0190
Phone (920) 269-4453

Other practice location 1

717 Water Street
Lomira, WI 53048-0190
Phone (920) 269-4453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151217001770 WI Order and Referring Only - DentistPractitioner - Dentist 5890096754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WI 2713WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Assosiates PastSince Dec 6, 2022 Accepting new patients
Dental Associates LTD of Wisconsin General Practice PastSince Dec 6, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1215948880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "address_2": "717 S WATER ST",
            "city": "LOMIRA",
            "state": "WI",
            "postal_code": "530480190",
            "telephone_number": "920-269-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 E JOHNSON ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549352856",
            "telephone_number": "920-924-9090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "717 Water Street",
            "address_purpose": "LOCATION",
            "city": "Lomira",
            "state": "WI",
            "postal_code": "530480190",
            "country_code": "US",
            "telephone_number": "920-269-4453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LLOYD",
        "first_name": "CAILYN",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "WI 2713",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "WI 2713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.