Familia Dental Springfiedl 5 LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FAMILIA DENTAL SPRINGFIEDL 5 LLC

Practice address

802 N 9TH St
Springfield, IL 62702-6309

Phone

(888) 988-4066

Fax

(847) 496-7603

NPI assigned

Jun 27, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Koushan Azad, DMD

Title

President

Phone

(888) 988-4066

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1750645495",
    "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": "888-988-4066",
            "fax_number": "847-496-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 N 9TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026309",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILIA DENTAL SPRINGFIEDL 5 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "AZAD",
        "authorized_official_first_name": "KOUSHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-988-4066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Anthony Fabrizio, PT
• John H Fahey, M.D.
• Stephanie Nicole Fahey, M.S. CCC-SLP
• Saif Faiek
• Kathleen M Faloon, CCC-A
• Familia Dental Springfield 2 LLC
• Familia Dental Springfield 3 LLC
• Familia Dental Springfield 4 LLC
• Familia Dental Springfield LLC
• Family Chiropractic Center of Madison County

• General Practice Dentistry in Springfield, IL
• Providers in Springfield, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.