NPIMap

Organization Active NPI

Dentistry for Madison, LLC

  • General Practice Dentistry
  • Madison, WI
National Provider Identifier
1669640108
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4304 Issued in WI
Legal business name
DENTISTRY FOR MADISON, LLC
Practice address
413 W Washington Ave
Madison, WI 53703-2703
Phone
(608) 251-8790
Fax
(608) 251-0242
NPI assigned
Feb 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Ms. Diann Kielley Corbett
Title
Office Manager
Phone
(608) 251-8790

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 5169 WI
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 4304 WI Primary

Addresses

Primary practice location

413 W Washington Ave
Madison, WI 53703-2703

Mailing address

413 W Washington Ave
Madison, WI 53703-2703
Phone (608) 251-8790

National Provider Directory

National Provider Directory

Locations

413 W Washington Ave
Madison, WI 53703
Phone (608) 251-8790

Practitioners & affiliated clinicians

Practitioners 4

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": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1669640108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032703",
            "telephone_number": "608-251-8790",
            "fax_number": "608-251-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 W WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032703",
            "telephone_number": "608-251-8790",
            "fax_number": "608-251-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY FOR MADISON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "KIELLEY CORBETT",
        "authorized_official_first_name": "DIANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "608-251-8790",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5169",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.