Familia Dental Madison West LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FAMILIA DENTAL MADISON WEST LLC

Practice address

706 S Gammon Rd
Madison, WI 53719-1302

Phone

(888) 988-4066

Fax

(847) 496-4850

NPI assigned

Mar 31, 2016

Last updated

Oct 15, 2021By 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. Brandon Alexander Taylor, CPCS

Title

Credentialing & Payer Relations MGR

Phone

(847) 453-7396

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1699138297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD",
            "address_2": "SUITE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734144",
            "telephone_number": "847-453-7396",
            "fax_number": "847-453-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 S GAMMON RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191302",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILIA DENTAL MADISON WEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "CREDENTIALING & PAYER RELATIONS MGR",
        "authorized_official_telephone_number": "847-453-7396",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPCS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Castaneda Falls, MD
• Cody Joseph Falls
• John Michael Fallucca, M.D.
• Kelly Marie Faltersack, RDN
• Familia Dental Madison East LLC
• Family Chiropractic Clinic Inc (Madison Chiropractic North)
• Family Service Madison Inc
• Family Support and Resource Center
• Family Therapy Center of Madison, Inc.
• Family Works Programs, Inc. (Family Works)

• Dental Clinic/Center in Madison, WI
• Providers in Madison, WI by specialty
• Dental Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.

Verify at the official NPI Registry.