PERIODONTAL & IMPLANT SPECIALISTS OF MADISON, LLC (NPI# 1366614885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366614885 |
| Entity Type | Organization |
| Organization Name | PERIODONTAL & IMPLANT SPECIALISTS OF MADISON, LLC |
| Practice Address |
49 N Walbridge Ave. Madison WI 53717 |
| Mailing Address |
2971 Chapel Valley Rd. Fitchburg WI 57311-7240 |
| Practice Telephone | 6088332578 |
| Practice Fax Number | 6082037105 |
| Mailing Telephone | 6086616400 |
| Mailing Fax Number | 6086616414 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-08-27 |
| Authorized Official Name | JAN K STREICH (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 6086616412 |
| Is Organization Subpart | Y |
| Parent Organization Name | DENTAL HEALTH ASSOCIATES OF MADISON LTD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 6136 | WI | Dental Providers |
| N | 122300000X | Dentist | 6215 | WI | Dental Providers |
| Y | 122300000X | Dentist | 3628 | WI | Dental Providers |
| Street Address |
49 N WALBRIDGE AVE. |
| City | MADISON |
| State | WI |
| Zip Code | 53717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720540164 | Apex Chiropractic Center LLC | Chiropractor | 562 Junction Road, Madison, WI 53717 | 2019-04-04 |
| 1467943795 | Brittany Macrander | Speech-Language Pathologist | 701 Deming Way, Madison, WI 53717 | 2018-05-22 |
| 1144622614 | Christopher Leclair | Pharmacist | 7942 Tree Ln, Suite 201, Madison, WI 53717 | 2014-09-16 |
| 1740617430 | Martha Darlene Kniffin | Marriage & Family Therapist | 1805 Excelsior Dr, The Family Center, Madison, WI 53717 | 2013-09-26 |
| 1740538305 | Amber J Thompson | Specialist | 8202 Excelisor Dr, Madison, WI 53717 | 2012-08-29 |
| 1457622938 | Kimberly F Lauth | Physician Assistant | 1200 Q Hammons Drive, Suite 400, Madison, WI 53717 | 2012-01-16 |
| 1699042499 | Cameron K Birch | Pharmacist | 9741 Tree Lane, Suite 201, Madison, WI 53717 | 2011-11-22 |
| 1508023102 | Katherine Jo Hartkopf | Pharmacist | 8501 Excelsior Drive, Rm. 337, Madison, WI 53717 | 2008-05-21 |
| 1598961005 | John H Greist | Psychiatry & Neurology | Healthcare Technology Systems, Inc., 7617 Mineral Point Rd., Ste. 300, Madison, WI 53717 | 2007-06-22 |
| 1417169160 | Children's Dental Center of Madison, S.c. | Dentist | 7001 Old Sauk Road, #200, Madison, WI 53717 | 2007-05-04 |
| Find all providers in zip 53717 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548875305 | Andre Oliveira-shahinfar | Dentist | 6038 Gemini Dr, Madison, WI 53718-3008 | 2020-09-09 |
| 1689286254 | Rajdeepsinh Narendrasinh Dolia | Dentist | 12205 County Line Rd Ste A, Madison, AL 35758-7720 | 2020-08-17 |
| 1841815362 | Payalben Baldev Patel | Dentist | 117 Fontanelle Blvd, Madison, MS 39110-6846 | 2020-06-10 |
| 1649824830 | Applewhite Dental Wisconsin, P.C. | Dentist | 5610 Medical Cir Ste 10, Madison, WI 53719-1284 | 2019-07-26 |
| 1336792787 | Mary Catherine Decker | Dentist | 8002 Watts Rd, Madison, WI 53719-3811 | 2019-07-24 |
| 1639739345 | Matthew Douglas Smith | Dentist | 500 Lentz Dr Ste 90a, Madison, TN 37115-5135 | 2019-06-14 |
| 1790277432 | Allison Reimer | Dentist | 4602 E Washington Ave, Madison, WI 53704-3236 | 2018-05-30 |
| 1629599683 | Melissa Ashlee Morrison | Dentist | 7617 Mineral Point Rd Ste 120, Madison, WI 53717-1623 | 2017-06-29 |
| 1336692417 | Danielle Marie Meirick | Dentist | 434 Sidney St, Madison, WI 53703-1724 | 2016-07-26 |
| 1649648858 | Terry A. Burgess | Dentist | 810 Palmer Plaza, # 103, Madison, AL 35758 | 2015-09-03 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.