NPIMap

Organization Active NPI

The Family Dentists

  • General Practice Dentistry
  • Union Grove, WI
National Provider Identifier
1609948967
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4398 Issued in WI
Legal business name
THE FAMILY DENTISTS
Practice address
1680 15TH Ave
Union Grove, WI 53182-1525
Phone
(262) 878-1500
Fax
(262) 878-4782
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John R Ulloa, D.M.D.NPI 1871759985
Title
Owner
Phone
(262) 878-1500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4398 WI Primary

Addresses

Primary practice location

1680 15TH Ave
Union Grove, WI 53182-1525

Mailing address

1680 15TH Ave
Union Grove, WI 53182-1525
Phone (262) 878-1500

National Provider Directory

National Provider Directory

Locations

1680 15th Ave
Union Grove, WI 53182
Phone (262) 878-1500

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609948967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 15TH AVE",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821525",
            "telephone_number": "262-878-1500",
            "fax_number": "262-878-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 15TH AVE",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821525",
            "telephone_number": "262-878-1500",
            "fax_number": "262-878-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY DENTISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ULLOA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-878-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.