Mayfaif Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

6448-15 Issued in WI

Legal business name

MAYFAIF FAMILY DENTISTRY

Practice address

11637 W North Ave
Wauwatosa, WI 53226-2129

Phone

(414) 259-0665

NPI assigned

Aug 5, 2017

Last updated

Aug 5, 2017By 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

Lakisha Arif-Holmes

Title

Dentist/Owner

Phone

(414) 259-0665

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Mayfair Family Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mayfair Family Dentistry

  • Dentist
  • Wauwatosa, WI
  • NPI 1336636547
  NPD tax ID

Locations

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

{
    "created_epoch": "1501891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501891200000",
    "number": "1225553753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11637 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11637 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262129",
            "telephone_number": "414-259-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYFAIF FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-05",
        "last_updated": "2017-08-05",
        "status": "A",
        "authorized_official_last_name": "ARIF-HOLMES",
        "authorized_official_first_name": "LAKISHA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "414-259-0665"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "6448-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982867024",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maxim Healthcare Services, Inc.
• Jennifer L Maxwell, LCSW
• Korrin May-Bretl, PTA
• Michelle J May, D.M.D.
• Katelyn Maydaniuk, DPT
• Mayfair Dental Care: Implants, Oral Surgery and Family Dental S.C.
• Mayfair Digestive Health Center, LLC
• Mayfair Family Dentistry
• Mayfair Foot Care Clinic S.C.
• Larry E MC Dowell, LMFT

• Dental Clinic/Center in Wauwatosa, WI
• Providers in Wauwatosa, 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 5, 2017; 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.