NPIMap

Organization Active NPI

Nebraska Dental Center

  • General Practice Dentistry
  • La Vista, NE
National Provider Identifier
1053198291
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NEBRASKA DENTAL CENTER
Practice address
8050 S 84TH St
La Vista, NE 68128-3303
Phone
(402) 331-1695
Fax
(402) 614-3954
NPI assigned
Sep 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Authorized official

Name
Keenan Fischman, DDSNPI 1023676467
Title
Owner/Manager
Phone
(402) 331-1695

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

8050 S 84TH St
La Vista, NE 68128-3303

Mailing address

8050 S 84TH St
La Vista, NE 68128-3303
Phone (402) 331-1695

National Provider Directory

National Provider Directory

Locations

8050 S 84th St
Lavista, NE 68128
Phone (402) 331-1695

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1053198291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8050 S 84TH ST",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681283303",
            "telephone_number": "402-331-1695",
            "fax_number": "402-614-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 S 84TH ST",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681283303",
            "telephone_number": "402-331-1695",
            "fax_number": "402-614-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEBRASKA DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "FISCHMAN",
        "authorized_official_first_name": "KEENAN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "402-331-1695",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Vista, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.