Active NPI
Tobin Norman Drake, D.D.S
- Endodontics
- Omaha, NE
National Provider Identifier
1134317845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 08496
- Practice address
- 9202 W Dodge Rd Ste 301
Omaha, NE 68114-3318 - Phone
- (402) 397-3636
- Fax
- (402) 397-1055
- NPI assigned
- Oct 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 08496 | IA | Primary |
Addresses
Primary practice location
9202 W Dodge Rd Ste 301
Omaha, NE 68114-3318
Mailing address
9202 W Dodge Rd Ste 301
Omaha, NE 68114-3318
Phone (402) 397-3636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 5, 2016 through Jan 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08496 | IA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1134317845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9202 W DODGE RD STE 301",
"city": "OMAHA",
"state": "NE",
"postal_code": "681143318",
"telephone_number": "402-397-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9202 W DODGE RD STE 301",
"city": "OMAHA",
"state": "NE",
"postal_code": "681143318",
"telephone_number": "402-397-3636",
"fax_number": "402-397-1055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "TOBIN",
"middle_name": "NORMAN",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-09",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "IA",
"license": "08496",
"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 Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.