Callaway Family Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CALLAWAY FAMILY DENTAL LLC

Practice address

2424 N Bluff St
Fulton, MO 65251-2709

Phone

(573) 642-6904

NPI assigned

Nov 16, 2022

Last updated

Nov 16, 2022By 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

Alex Madov, DDSNPI 1528637980

Title

Member

Phone

(402) 850-9285

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alex Madov, DDS

  • Dentist
  • Fulton, MO
  • NPI 1528637980
  NPD Authorized official

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1699484840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 N BLUFF ST",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652512709",
            "telephone_number": "573-642-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 N BLUFF ST",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652512709",
            "telephone_number": "573-642-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLAWAY FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "MADOV",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "402-850-9285",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Callaway County Special Services (Brady and Fisher Apartments (AKA Liberty and Callaway Apartments))
• Callaway County Special Services (Adult Enrichment Center)
• Callaway County Special Services
• Callaway Emergency Group LLC
• Callaway Emergency Physicians, LLC
• Callaway Internal Medicine Group
• Callaway Internal Medicine Group
• Calloway Physician Services LLC
• Justin Ryan Campbell, OTR/L
• Robert A Carroll, CNA

• Dental Clinic/Center in Fulton, MO
• Providers in Fulton, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.