Healthcare Provider Details

I. General information

NPI: 1467379750
Provider Name (Legal Business Name): ISTHMUS FAMILY DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 E JOHNSON ST
MADISON WI
53703-2120
US

IV. Provider business mailing address

122 E JOHNSON ST
MADISON WI
53703-2120
US

V. Phone/Fax

Practice location:
  • Phone: 608-257-0116
  • Fax:
Mailing address:
  • Phone: 608-257-0116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: GOLDEN VU
Title or Position: DOCTOR
Credential: DDS
Phone: 608-704-7470