NPIMap

Organization Active NPI

Madison Dental Initiative

  • Dentist
  • Madison, WI
National Provider Identifier
1760719827
Registry record updated Nov 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5729-015 Issued in WI
Legal business name
MADISON DENTAL INITIATIVE
Practice address
630 E Washington Ave
Madison, WI 53703-2917
Phone
(608) 256-2321
NPI assigned
Nov 11, 2009
Last updated
Nov 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2009

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

Authorized official

Name
Ms. Lisa Ann Bell, BASDH, MPH-D
Title
Director
Phone
(608) 497-0275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5729-015 WI Primary

Addresses

Primary practice location

630 E Washington Ave
Madison, WI 53703-2917

Mailing address

3834 Cosgrove Dr
Madison, WI 53719-1856
Phone (608) 497-0275

National Provider Directory

National Provider Directory

Locations

630 E Washington Ave
Madison, WI 53703
Phone (608) 256-2321

NPI Registry JSON

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257897600000",
    "number": "1760719827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3834 COSGROVE DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191856",
            "telephone_number": "608-497-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E WASHINGTON AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032917",
            "telephone_number": "608-256-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON DENTAL INITIATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-11",
        "last_updated": "2009-11-11",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "608-497-0275",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BASDH, MPH-D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "5729-015",
            "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 Nov 11, 2009; 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.