Active NPI
Madison Rose Geliche, DMD
- Dentist
- Kenosha, WI
National Provider Identifier
1609444363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1002562-15
- Practice address
- 3415 30TH Ave
Kenosha, WI 53144-1622 - Phone
- (262) 654-0267
- NPI assigned
- Jun 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1002562-15 | WI | Primary |
Addresses
Primary practice location
3415 30TH Ave
Kenosha, WI 53144-1622
Mailing address
3415 30TH Ave
Kenosha, WI 53144-1622
Phone (262) 654-0267
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | aiellofamilydental.com | Direct | |
| CONNECT URL | aiellofamilydental.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1002562-15 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623888000000",
"number": "1609444363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3415 30TH AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531441622",
"telephone_number": "262-654-0267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3415 30TH AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531441622",
"telephone_number": "262-654-0267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GELICHE",
"first_name": "MADISON",
"middle_name": "ROSE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-17",
"last_updated": "2021-06-17",
"certification_date": "2021-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1002562-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "aiellofamilydental.com",
"affiliation": "N",
"endpointDescription": "business website",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3415 30th Ave",
"city": "Kenosha",
"state": "WI",
"country_code": "US",
"postal_code": "531441622",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "aiellofamilydental.com",
"affiliation": "N",
"endpointDescription": "Business website",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3415 30th Ave",
"city": "Kenosha",
"state": "WI",
"country_code": "US",
"postal_code": "531441622",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.