Campfire Pediatric Dentistry, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CAMPFIRE PEDIATRIC DENTISTRY, LLC

Practice address

8391 Greenway Blvd Ste 100
Middleton, WI 53562-3544

Phone

(815) 979-3837

NPI assigned

Sep 20, 2021

Last updated

Apr 28, 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

Nathanael D Benassi, DDSNPI 1225461247

Title

Member

Phone

(608) 535-9382

Specialties & licenses 2

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.

• Nathanael David Benassi, D.D.S.

  • Pediatric Dentistry
  • Middleton, WI
  • NPI 1225461247
  NPD Authorized official

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1881364958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8391 GREENWAY BLVD STE 100",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623544",
            "telephone_number": "608-535-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8391 GREENWAY BLVD STE 100",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623544",
            "telephone_number": "815-979-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPFIRE PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "BENASSI",
        "authorized_official_first_name": "NATHANAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "608-535-9382",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Gage Buttery
• Brandon S Bykowski, MSW, LCSW-SA
• Diana Lynn Cairo, MASTER OF ARTS
• Kristin Elisabeth Caldera, D.O.
• Denise Marie Calhoun, PH.D
• Miguel Cardenas
• Career Support LLC
• Megan K Carlson, CCC-SLP
• Rochelle M Carlson, NP
• Greta Carlsson

• Pediatric Dentistry in Middleton, WI
• Providers in Middleton, WI by specialty
• Pediatric Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.