Individual provider Active NPI

James E Canarsky, D.D.S.

  • General Practice Dentistry
  • Lincoln, NE
National Provider Identifier
1063582021
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5262 Issued in NE
Practice address
2838 S 48TH St
Lincoln, NE 68506-3391
Phone
(402) 488-8670
Fax
(402) 488-2932
NPI assigned
Nov 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5262 NE Primary

Addresses

Primary practice location

2838 S 48TH St
Lincoln, NE 68506-3391

Mailing address

PO Box 67127
Lincoln, NE 68506-7127
Phone (402) 488-8670

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150414001064 NE Order and Referring Only - Other (Non-Physician) 9133447667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5262NEMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063582021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67127",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685067127",
            "telephone_number": "402-488-8670",
            "fax_number": "402-488-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2838 S 48TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685063391",
            "telephone_number": "402-488-8670",
            "fax_number": "402-488-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANARSKY",
        "first_name": "JAMES",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "5262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.