NPIMap

Organization Active NPI

Fremont Dental Group PC

Doing business as Fremont Dental Group

  • General Practice Dentistry
  • Fremont, NE
National Provider Identifier
1093465361
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FREMONT DENTAL GROUP PC
Doing business as
Fremont Dental Group
Practice address
1435 E 23Rd St
Fremont, NE 68025-2433
Phone
(402) 727-9100
NPI assigned
Mar 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Authorized official

Name
Vicenta Reyes
Title
Lead of Credentialing
Phone
(972) 869-3789

Specialties & licenses 1

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

Addresses

Primary practice location

1435 E 23Rd St
Fremont, NE 68025-2433

Mailing address

1435 E 23Rd St
Fremont, NE 68025-2433
Phone (402) 727-9100

Other names 1

  • Fremont Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

1435 E 23rd St
Fremont, NE 68025
Phone (402) 727-9100

Practitioners & affiliated clinicians

Practitioners 5

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": "1648425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1093465361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 E 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252433",
            "telephone_number": "402-727-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 E 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252433",
            "telephone_number": "402-727-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "VICENTA",
        "authorized_official_title_or_position": "LEAD OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fremont Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.