Micah Todd Jeppesen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6101 Issued in NE

Practice address

10274 S 71St St
Papillion, NE 68133

Phone

(402) 339-2501

Fax

(402) 339-2503

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Your Family Dentist P.C.

  • General Practice Dentistry
  • Papillion, NE
  • NPI 1053094177
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1023179959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10274 S 71ST ST",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "68133",
            "telephone_number": "402-339-2501",
            "fax_number": "402-339-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10274 S 71ST ST",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "68133",
            "telephone_number": "402-339-2501",
            "fax_number": "402-339-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPPESEN",
        "first_name": "MICAH",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47083321900",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Jenkins
• Deann Kay Jensen
• Erin Jensen, RN
• Jaden Jensen
• Addison Blair Jeppesen, DDS, MS
• Palmer Jeppesen, DMD
• Jerry G Damme O.D.,P.C.
• Renee Janine Jibben
• Sally J Jochens, APRN
• Aya Johnson

• General Practice Dentistry in Papillion, NE
• Providers in Papillion, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.