NPIMap

Organization Active NPI

Famila Dental Marion LLC

  • Dentist
  • Marion, IN
National Provider Identifier
1437595022
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011918A Issued in IN
Legal business name
FAMILA DENTAL MARION LLC
Practice address
1903 S Western Ave
Marion, IN 46953
Phone
(888) 988-4066
Fax
(847) 496-7603
NPI assigned
May 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2013

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

Authorized official

Name
Koushan Azad
Title
Owner
Phone
(888) 988-4066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 12011918A IN Primary

Addresses

Primary practice location

1903 S Western Ave
Marion, IN 46953

Mailing address

1903 S Western Ave
Marion, IN 46953
Phone (888) 988-4066

Other names 1

  • Familia Dental Marion LLC Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369180800000",
    "number": "1437595022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 S WESTERN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "46953",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 S WESTERN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "46953",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILA DENTAL MARION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-22",
        "last_updated": "2013-05-22",
        "status": "A",
        "authorized_official_last_name": "AZAD",
        "authorized_official_first_name": "KOUSHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-988-4066"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011918A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Familia Dental Marion LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marion, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; 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.