NPIMap

Organization Active NPI

Husker Dental PC

  • Dentist
  • Omaha, NE
National Provider Identifier
1063897825
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6791 Issued in NE
Legal business name
HUSKER DENTAL PC
Practice address
8710 N 30TH St
Omaha, NE 68112-1810
Phone
(402) 451-7407
NPI assigned
Jul 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Authorized official

Name
Dr. Jaya Maniktala, DDSNPI 1427240316
Title
President
Phone
(402) 451-7407

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
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 6791 NE Primary

Addresses

Primary practice location

8710 N 30TH St
Omaha, NE 68112-1810

Mailing address

8710 N 30TH St
Omaha, NE 68112-1810
Phone (402) 451-7407

Other identifiers 1

IdentifierTypeStateIssuer
10026420100MedicaidNE

National Provider Directory

National Provider Directory

Locations

8710 N 30th St
Omaha, NE 68112
Phone (402) 451-7407

Practitioners & affiliated clinicians

Practitioners 1

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": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437523200000",
    "number": "1063897825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8710 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681121810",
            "telephone_number": "402-451-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 N 30TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681121810",
            "telephone_number": "402-451-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUSKER DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2015-07-22",
        "status": "A",
        "authorized_official_last_name": "MANIKTALA",
        "authorized_official_first_name": "JAYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-451-7407",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NE",
            "license": "6791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026420100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; 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.