NPIMap

Organization Active NPI

Premier Smile Dental Associates, PC

Doing business as Premier Dental

  • General Practice Dentistry
  • Omaha, NE
National Provider Identifier
1104162601
Registry record updated Mar 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6254 Issued in NE
Legal business name
PREMIER SMILE DENTAL ASSOCIATES, PC
Doing business as
Premier Dental
Practice address
17110 Lakeside Hills Plaza
Omaha, NE 68130
Phone
(402) 330-6757
Fax
(402) 330-6713
NPI assigned
Jan 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2022

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

Authorized official

Name
Dr. Daniel J Beninato, D.D.S.NPI 1831211739
Title
Owner
Phone
(402) 330-6757

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 6254 NE Primary

Addresses

Primary practice location

17110 Lakeside Hills Plaza
Omaha, NE 68130

Mailing address

17110 Lakeside Hills Plaza
Omaha, NE 68130
Phone (402) 330-6757

Other names 1

  • Premier Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifetime Family Dental PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

17110 Lakeside Hills Plz
Omaha, NE 68130
Phone (402) 330-5767

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": "1357084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646524800000",
    "number": "1104162601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17110 LAKESIDE HILLS PLAZA",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68130",
            "telephone_number": "402-330-6757",
            "fax_number": "402-330-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17110 LAKESIDE HILLS PLAZA",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68130",
            "telephone_number": "402-330-6757",
            "fax_number": "402-330-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SMILE DENTAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-02",
        "last_updated": "2022-03-06",
        "certification_date": "2022-03-06",
        "status": "A",
        "authorized_official_last_name": "BENINATO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-330-6757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 6, 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.