MADISON DENTAL LLC (NPI# 1417476458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417476458 |
| Entity Type | Organization |
| Organization Name | MADISON DENTAL LLC |
| Practice Address |
2110 Fordem Ave Madison WI 53704-4610 |
| Practice Telephone | 6082449124 |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2017-09-11 |
| Authorized Official Name | KELLY BARES (OWNER) |
| Authorized Official Telephone | 3093693284 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467909952 | Madison Dental LLC | Dentist | 15020 Shady Grove Road, Suite 360, Rockville, MD 20850 | 2016-09-01 |
| Street Address |
2110 FORDEM AVE |
| City | MADISON |
| State | WI |
| Zip Code | 53704-4610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780799239 | Timothy C Turino | Chiropractor | 2110 Fordem Ave, Madison, WI 53704-4610 | 2006-08-21 |
| 1952956062 | Phillip Maxwell Hsu | Chiropractor | 2110 Fordem Ave, Madison, WI 53704-4610 | 2019-08-06 |
| 1275075558 | Jesse Easley | Chiropractor | 2110 Fordem Ave, Madison, WI 53704-4610 | 2016-11-17 |
| 1982941399 | Schupp Chiropractic and Sports Injuries LLC | Chiropractor | 2110 Fordem Ave, Madison, WI 53704-4610 | 2013-01-07 |
| 1639415698 | Andrew Charles Schupp | Chiropractor | 2110 Fordem Ave, Madison, WI 53704-4610 | 2012-12-19 |
| 1225154198 | Steven Barry Eaton | Dentist | 2110 Fordem Ave, Madison, WI 53704-4610 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407369614 | Joseph Michael Oakley II | Chiropractor | 2801 International Ln Ste 102, Madison, WI 53704 | 2017-11-09 |
| 1972015048 | Suzanne Lee | Psychiatry & Neurology | 1835 Winnebago St. #402, Madison, WI 53704 | 2017-10-30 |
| 1831554021 | Gideon Kazah | Licensed Practical Nurse | 2488 Dahle Street, Madison, WI 53704 | 2015-12-15 |
| 1174952220 | Group Health Cooperative of South Central Wisconsin Madison College | Durable Medical Equipment & Medical Supplies | 1705 Hoffman Street, Madison, WI 53704 | 2013-11-08 |
| 1407190127 | Ashley Marie Snyder | Social Worker | 5203 Autumn Leaf Lane, Apt. 389, Madison, WI 53704 | 2012-11-19 |
| 1619230638 | Dawn Lynette Butts | Optometrist | 4208 E Washington Ave, Madison, WI 53704 | 2012-06-25 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1578730412 | St. Charles Youth & Family Services | Community Based Residential Treatment Facility, Mental Illness | 310 Troy Dr, Cottage B, Madison, WI 53704 | 2008-05-09 |
| 1538346960 | Elizabeth Ann Reiser-loeber | Dentist | 1001 N. Sherman Ave, Madison, WI 53704 | 2008-01-28 |
| 1861683088 | Stephen Dale Flach | Internal Medicine | Covance, 3402 Kinsman Blvd, Madison, WI 53704 | 2007-08-05 |
| Find all providers in zip 53704 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790343051 | Madison Dental Spa | Clinic/Center | 90 Wall St Ste 100, Madison, CT 06443-3128 | 2019-06-03 |
| 1306301072 | Dr. Lee Gus Dunker | Clinic/Center | 424 West St, Madison, IN 47250-3302 | 2019-02-06 |
| 1518422880 | Bright Dental Madison LLC | Clinic/Center | 7866 Mineral Point Rd, Madison, WI 53717-2028 | 2019-01-31 |
| 1992217053 | Great Day Dental of Monona | Clinic/Center | 2010 Eastwood Dr Ste 206, Madison, WI 53704-5387 | 2017-10-30 |
| 1770913220 | L.l. Barnett Dental Solutions, P.C. | Clinic/Center | 7185 Highway 72 W Ste C, Madison, AL 35758-6650 | 2013-11-20 |
| 1114210481 | Abcom Family Dental Care | Clinic/Center | 5402 Mineral Point Rd, Madison, WI 53705-4659 | 2011-05-19 |
| 1790976553 | Dr Andrew D Friedman Dmd | Clinic/Center | 21 Old Point Ave, Madison, ME 04950-1114 | 2007-08-07 |
| 1235351750 | Madison Dental Care | Clinic/Center | 535 Gallatin Pike S, Madison, TN 37115-4010 | 2007-05-03 |
| 1386209849 | Southeastern Dental Pllc | Clinic/Center | 117 Gallatin Pike N, Madison, TN 37115-3701 | 2019-05-09 |
| 1417421421 | Kevin L. Klinedinst Dds PC | Clinic/Center | 110 Miles Ridge Rd, Madison, IN 47250-2410 | 2019-01-14 |
| 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.