Brendan Matthew Lane, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

052483 Issued in NY

Practice address

2501 Capehart Rd
Offutt Afb, NE 68113-1043

Phone

(402) 294-1165

NPI assigned

Sep 7, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1003800970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043",
            "telephone_number": "402-294-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CAPEHART RD",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681131043",
            "telephone_number": "402-294-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "BRENDAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052483",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda K Kronley, RDH
• Jennifer Jones Laack, AU.D.
• Kyle Andrew Land, DDS
• Marcela Land, DDS
• Latraia Shanae Landrum, MD
• Rebecca Lauters, M.D.
• Arthur New Lawrance Jr., DO
• Ketu P Lincoln, DMD
• Kristina Marie Linden, LICSW
• Douglas Scott Lindner, PA-C

• All providers in Offutt Afb, NE
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.