NPIMap

Organization Active NPI

MK Optical Enterprises, Inc

  • Optometrist
  • Lincoln, NE
National Provider Identifier
1124209598
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1257 Issued in NE
Legal business name
MK OPTICAL ENTERPRISES, INC
Practice address
5801 S 58TH St
Ste a
Lincoln, NE 68516-6404
Phone
(402) 423-5367
Fax
(402) 420-5841
NPI assigned
Nov 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Dr. Matthew Wade Dinslage, O.D.NPI 1811901481
Title
President
Phone
(402) 423-5367

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1257 NE Primary

Addresses

Primary practice location

5801 S 58TH St
Ste a
Lincoln, NE 68516-6404

Mailing address

5801 S 58TH St
Ste a
Lincoln, NE 68516-6404
Phone (402) 423-5367

Other names 1

  • The Spectacle Place Doing business as

National Provider Directory

National Provider Directory

Locations

5801 S 58th St
Ste A
Lincoln, NE 68516
Phone (402) 423-5367

Practitioners & affiliated clinicians

Practitioners 2

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": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1124209598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 S 58TH ST",
            "address_2": "STE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166404",
            "telephone_number": "402-423-5367",
            "fax_number": "402-420-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 S 58TH ST",
            "address_2": "STE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166404",
            "telephone_number": "402-423-5367",
            "fax_number": "402-420-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MK OPTICAL ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "DINSLAGE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-423-5367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Spectacle Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.