Familia Dental Springfield LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FAMILIA DENTAL SPRINGFIELD LLC

Practice address

802 N 9TH St
Springfield, IL 62702-6309

Phone

(888) 988-4066

Fax

(847) 496-7603

NPI assigned

Apr 13, 2011

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 2

Addresses

Other names 1

• Familia Dental Doing business as

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1780974568",
    "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": "601734166",
            "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": "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 SPRINGFIELD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-13",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "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": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Familia Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Familia Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathleen M Faloon, CCC-A
• Familia Dental Springfiedl 5 LLC
• Familia Dental Springfield 2 LLC
• Familia Dental Springfield 3 LLC
• Familia Dental Springfield 4 LLC
• Family Chiropractic Center of Madison County
• Family Guidance Centers, Inc.
• Family Guidance Centers, Inc.
• Family Guidance Centers, Inc.
• Family Service Center of Sangamon County

• Dental Clinic/Center in Springfield, IL
• Providers in Springfield, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.