NPIMap

Organization Active NPI

Family First Dental Associates of Wausa, P.C.

Doing business as Family 1st Dental of Creighton

  • General Practice Dentistry
  • Creighton, NE
National Provider Identifier
1073789756
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY FIRST DENTAL ASSOCIATES OF WAUSA, P.C.
Doing business as
Family 1st Dental of Creighton
Practice address
615 Main St.
Creighton, NE 68729-0309
Phone
(402) 358-3484
Fax
(402) 358-3411
NPI assigned
May 2, 2008
Last updated
Jun 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Authorized official

Name
Ann L. Stoltenberg
Title
Family 1St Dental Support Manager
Phone
(712) 830-5356

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

615 Main St.
Creighton, NE 68729-0309

Mailing address

615 Main St. Box 309
Creighton, NE 68729-0309
Phone (402) 358-3484

Other names 1

  • Family 1st Dental of Creighton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family 1St Dental of Creighton8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

615 Main St
Creighton, NE 68729
Phone (402) 358-3484

615 Main St
#309
Creighton, NE 68729

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1073789756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MAIN ST. BOX 309",
            "city": "CREIGHTON",
            "state": "NE",
            "postal_code": "687290309",
            "telephone_number": "402-358-3484",
            "fax_number": "402-358-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MAIN ST.",
            "city": "CREIGHTON",
            "state": "NE",
            "postal_code": "687290309",
            "telephone_number": "402-358-3484",
            "fax_number": "402-358-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FIRST DENTAL ASSOCIATES OF WAUSA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "STOLTENBERG",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "FAMILY 1ST DENTAL SUPPORT MANAGER",
        "authorized_official_telephone_number": "712-830-5356"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family 1st Dental of Creighton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family 1st Dental of Creighton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Creighton, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.