Perio-Dental Implants, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

PERIO-DENTAL IMPLANTS, LLC

Doing business as

The Center for Periodontics and Dental Implants

Practice address

6301 University Ave
Middleton, WI 53562-3415

Phone

(608) 709-1240

Fax

(608) 819-8395

NPI assigned

Mar 2, 2015

Last updated

Mar 2, 2015By 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

Mr. Andrew Thomas Fabian

Title

Manager

Phone

(608) 712-6320

Specialties & licenses 1

Addresses

Other names 1

• The Center for Periodontics and Dental Implants Doing business as

Locations

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1669864542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY AVE",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623415",
            "telephone_number": "608-709-1240",
            "fax_number": "608-819-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY AVE",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623415",
            "telephone_number": "608-709-1240",
            "fax_number": "608-819-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIO-DENTAL IMPLANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "FABIAN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "608-712-6320",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center for Periodontics and Dental Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cody S. Paul
• Carley Paulseth, BS
• Cathie A Pauly, M.S., CCC-SP
• Alison Carol Peck, M.D.
• Geraldine Tatoy Pentinio, PT
• Sara E Perkins, MSSW
• Chloe Perlis, L.C.S.W.
• Jacob L Perlman
• Sean Paul Peronto, PA
• Kelly Peroutka, RN

• Periodontics in Middleton, WI
• Providers in Middleton, WI by specialty
• Periodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; 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.