NPIMap

Organization Active NPI

Fondy Family Dental

  • Dental Clinic/Center
  • Fond Du Lac, WI
National Provider Identifier
1962099101
Registry record updated Dec 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
FONDY FAMILY DENTAL
Practice address
35 W Scott St
Fond Du Lac, WI 54935-2342
Phone
(920) 922-2930
NPI assigned
Dec 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2020

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

Authorized official

Name
Chad Goeke, DMDNPI 1548619265
Title
Owner/Dentist
Phone
(815) 541-9561

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

35 W Scott St
Fond Du Lac, WI 54935-2342

Mailing address

35 W Scott St
Fond Du Lac, WI 54935-2342
Phone (920) 922-2930

Other identifiers 2

IdentifierTypeStateIssuer
1548619265MedicaidWI
1285780171MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Finance@krausdentistry.com Direct

National Provider Directory

National Provider Directory

Locations

35 W Scott St
Fond du Lac, WI 54935
Phone (920) 922-2930

Interoperability endpoints

  • Direct secure messaging: finance@krausdentistry.com

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608768000000",
    "number": "1962099101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 W SCOTT ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549352342",
            "telephone_number": "920-922-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W SCOTT ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549352342",
            "telephone_number": "920-922-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FONDY FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A",
        "authorized_official_last_name": "GOEKE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "815-541-9561",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548619265",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285780171",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Finance@krausdentistry.com",
            "affiliation": "N",
            "endpointDescription": "Office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email address",
            "address_1": "35 W Scott St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549352342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; 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.