Theis Family Dental, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

THEIS FAMILY DENTAL, PLLC

Practice address

107 1St Ave SW
Hutchinson, MN 55350-2403

Phone

(320) 310-8325

NPI assigned

Jul 31, 2024

Organization subpart

No

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

Authorized official

Name

Fallon Theis, DDSNPI 1407340524

Title

Owner Dentist

Phone

(320) 455-9345

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fallon Madeline Theis, DDS

  • Dentist
  • Litchfield, MN
  • NPI 1407340524
  NPD Authorized official

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1366271975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 1ST AVE SW",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553502403",
            "telephone_number": "320-310-8325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 1ST AVE SW",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553502403",
            "telephone_number": "320-310-8325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEIS FAMILY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "THEIS",
        "authorized_official_first_name": "FALLON",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "320-455-9345",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Suchy
• Leann F Sundhagen, OD
• Sigrid Szafranski, LPN
• Sherry Tauer-Nere
• Tenequa Shakell Terry, RN
• Jacqueline Marie Theisen, NCC, LPCC
• Kate Theisen, M.S. CF SLP
• Timothy Richard Theisen, PTA
• Thomas L Price Associates
• Beverly Ann Thomas, RN

• Dental Clinic/Center in Hutchinson, MN
• Providers in Hutchinson, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.