Active NPI
Northwest Dental, LLC
- General Practice Dentistry
- Omaha, NE
National Provider Identifier
1073406716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- NORTHWEST DENTAL, LLC
- Practice address
- 5200 N 91St Ave
Omaha, NE 68134-2749 - Phone
- (402) 572-7677
- NPI assigned
- Jun 2, 2025
- Last updated
- Jun 2, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brent Rising
- Title
- Member
- Phone
- (701) 799-6453
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | NU | Primary |
Addresses
Primary practice location
5200 N 91St Ave
Omaha, NE 68134-2749
Mailing address
27330 W Center Rd
Waterloo, NE 68069-6814
Phone (701) 799-6453
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Omaha, NE
- NPI 1558598961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748822400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1748822400000",
"number": "1073406716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27330 W CENTER RD",
"city": "WATERLOO",
"state": "NE",
"postal_code": "680696814",
"telephone_number": "701-799-6453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 N 91ST AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681342749",
"telephone_number": "402-572-7677"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHWEST DENTAL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-06-02",
"last_updated": "2025-06-02",
"certification_date": "2025-06-01",
"status": "A",
"authorized_official_last_name": "RISING",
"authorized_official_first_name": "BRENT",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "701-799-6453"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.