Individual provider Active NPI

Dirk Bradford Newington, D.D.S.

  • Dentist
  • Omaha, NE
National Provider Identifier
1114007655
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4892 Issued in NE
Practice address
13475 W Center Rd
Omaha, NE 68144-3412
Phone
(402) 333-1120
Fax
(402) 697-8713
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4892 NE Primary

Addresses

Primary practice location

13475 W Center Rd
Omaha, NE 68144-3412

Mailing address

13475 W Center Rd
Omaha, NE 68144-3412
Phone (402) 333-1120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4892NEMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114007655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13475 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443412",
            "telephone_number": "402-333-1120",
            "fax_number": "402-697-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13475 W CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443412",
            "telephone_number": "402-333-1120",
            "fax_number": "402-697-8713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWINGTON",
        "first_name": "DIRK",
        "middle_name": "BRADFORD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "4892",
            "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 Jul 8, 2007; 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.