Podoll Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PODOLL DENTAL, LLC

Doing business as

Fort Family Dental

Practice address

715 Sherman Ave E
Fort Atkinson, WI 53538-1992

Phone

(763) 360-0841

NPI assigned

Aug 29, 2017

Last updated

Jul 21, 2022By 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. Sara Podoll, DDSNPI 1073810115

Title

Dentist

Phone

(920) 563-4322

Specialties & licenses 1

Addresses

Other names 1

• Fort Family Dental Doing business as

Practitioners 1

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.

• Sara Podoll, DDS

  • General Practice Dentistry
  • Fort Atkinson, WI
  • NPI 1073810115
  Authorized official Same address or phone

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386161420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381992",
            "telephone_number": "920-563-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381992",
            "telephone_number": "763-360-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODOLL DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PODOLL",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "920-563-4322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peoplefirst Rehab
• Thomas Russell Perry, M.D.
• Stanley E Peterson, MD
• Pinnacle Assisted Living Services LLC
• Plantmental Counseling
• Sara Podoll, DDS
• Bonnie L Poppy, APNP
• Anne Prickette
• Tyler Joseph Prickette, PHARMD
• Prime Training, LLC (Prime Physical Therapy)

• Dental Clinic/Center in Fort Atkinson, WI
• Providers in Fort Atkinson, 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 Jul 21, 2022; 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.