NPIMap

Organization Active NPI

Dental Professionals of Nebraska, PC

  • General Practice Dentistry
  • Omaha, NE
National Provider Identifier
1124848254
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF NEBRASKA, PC
Practice address
19013 Oakmont Dr
Omaha, NE 68136-4345
Phone
(804) 575-3320
Fax
(804) 575-3324
NPI assigned
Oct 14, 2024
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF NEBRASKA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Cemyira McDougal
Title
Cred Coordinator
Phone
(217) 764-8609

Specialties & licenses 1

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

Addresses

Primary practice location

19013 Oakmont Dr
Omaha, NE 68136-4345

Mailing address

15884 Hull Street Rd
Chesterfield, VA 23832-2178
Phone (804) 575-3320

Other names 1

  • 370 Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Nebraska PC12 organizations share this tax ID, including this one
Part of
Dental Professionals of Nebraska PC

Other organizations with this tax ID 11

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

Locations

19013 Oakmont Dr
Omaha, NE 68136
Phone (804) 575-3320

15884 Hull Street Rd
Chesterfield, VA 23832
Phone (804) 575-3320

NPI Registry JSON

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1124848254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15884 HULL STREET RD",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238322178",
            "telephone_number": "804-575-3320",
            "fax_number": "804-575-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19013 OAKMONT DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681364345",
            "telephone_number": "804-575-3320",
            "fax_number": "804-575-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF NEBRASKA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF NEBRASKA, P.C.",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CRED COORDINATOR",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "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": "370 Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "370 Dental Care",
            "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 Oct 21, 2024; 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.