DR. MADISON FANTIN DDS NPI 1043805526

NPI Information

  • NPI: 1043805526
  • Provider Name: DR. MADISON FANTIN, DDS
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Individual
  • Address: 2300 HAGGERTY RD STE 1180
    WEST BLOOMFIELD, MI
    ZIP 48323
  • Phone: (248) 787-2037

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NPI Details

DR. Madison Fantin, DDS is a pediatric dentistry dentist in West Bloomfield, MI. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Madison Fantin, DDS NPI is 1043805526. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2300 HAGGERTY RD STE 1180
WEST BLOOMFIELD, MI
ZIP 48323-188
Phone: (248) 787-2037

The enumeration date for this NPI number is 3/5/2021 and was last updated on 7/13/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
21223P0221XDentistPediatric Dentistry2901601213MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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