Individual provider Active NPI

Peter Roy Straub, D.D.S.

  • General Practice Dentistry
  • Omaha, NE
National Provider Identifier
1003855602
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5841 Issued in NE
Practice address
15909 W Maple Rd
Suite 102
Omaha, NE 68116-2004
Phone
(402) 991-6965
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5841 NE Primary

Addresses

Primary practice location

15909 W Maple Rd
Suite 102
Omaha, NE 68116-2004

Mailing address

15909 W Maple Rd
Suite 102
Omaha, NE 68116-2004
Phone (402) 991-6965

Other identifiers 2

IdentifierTypeStateIssuer
05489OtherNEBCBS PROVIDER #
969607OtherNEUNITED CONCORDIA PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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

Enrollment IDStateProvider typePAC IDDetails
I20190530002463 NE Order and Referring Only - DentistPractitioner - Dentist 3779816061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
5841NEMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1003855602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15909 W MAPLE RD",
            "address_2": "SUITE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162004",
            "telephone_number": "402-991-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15909 W MAPLE RD",
            "address_2": "SUITE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162004",
            "telephone_number": "402-991-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAUB",
        "first_name": "PETER",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "5841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "05489",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "969607",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.