Fort Family Dental Center, SC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2255 Issued in WI

Legal business name

FORT FAMILY DENTAL CENTER, SC

Practice address

715 Sherman Ave E
Fort Atkinson, WI 53538-1992

Phone

(920) 563-4322

Fax

(920) 563-6585

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

David Luisier, D.D.S.

Title

President

Phone

(920) 563-4322

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1942314067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381992",
            "telephone_number": "920-563-4322",
            "fax_number": "920-563-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381992",
            "telephone_number": "920-563-4322",
            "fax_number": "920-563-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT FAMILY DENTAL CENTER, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "LUISIER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-563-4322",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "2255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rene Jean Foelker, RN
• Gregory James Foley, CRNA
• Jamie L Foltz, CRNA
• Fort Atkinson Emergency Physicians, S.C.
• Fort Atkinson Wi Opco LLC
• Fort Healthcare Inc
• Fort Healthcare Inc
• Fort Healthcare, Inc (Fort Healthcare Home Health)
• Fort Healthcare, Inc. (Fort Healthcare Subacute Care)
• Fort Healthcare, Inc.

• General Practice Dentistry in Fort Atkinson, WI
• Providers in Fort Atkinson, 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 Aug 20, 2008; 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.