Kiel Family Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6322-15 Issued in WI

Legal business name

KIEL FAMILY DENTAL LLC

Practice address

403 Fremont St
Kiel, WI 53042-1316

Phone

(920) 898-2305

Fax

(920) 894-3048

NPI assigned

Mar 29, 2016

Last updated

Mar 29, 2016By 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

Gregory Furdek, D.D.S.

Title

Owner / Dentist

Phone

(920) 898-2305

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.

• Constance Annie Wallander, D.M.D.

  • Dentist
  • Kiel, WI
  • NPI 1063722643
  NPD (past)

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1922461888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 FREMONT ST",
            "city": "KIEL",
            "state": "WI",
            "postal_code": "530421316",
            "telephone_number": "920-898-2305",
            "fax_number": "920-894-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 FREMONT ST",
            "city": "KIEL",
            "state": "WI",
            "postal_code": "530421316",
            "telephone_number": "920-898-2305",
            "fax_number": "920-894-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIEL FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "FURDEK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER / DENTIST",
        "authorized_official_telephone_number": "920-898-2305",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6322-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cary A Johannes, PSYD
• Pamela Ann Kachelmeier, MA, PC (EAMH)
• Barbara Lynn Karls, DDS
• Tina Karls, RN
• Kiel Area School District
• Kiel Veterinary Clinic
• Becky D Kissinger, PT, DPT
• Jordyn Catherine Kohlmann, PHARMD.
• Caitlin Moorea Kravick
• Dale Jeanne Lehrer, P.T.

• General Practice Dentistry in Kiel, WI
• Providers in Kiel, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.