Individual provider Active NPI

Dede Agbaleti

  • Licensed Practical Nurse
  • Omaha, NE
National Provider Identifier
1144149352
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
28753 Issued in NE
Practice address
220 N 89TH St Ste 202
Omaha, NE 68114-4072
Phone
(402) 502-5750
Fax
(402) 502-5750
NPI assigned
Jul 13, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 28753 NE Primary

Addresses

Primary practice location

220 N 89TH St Ste 202
Omaha, NE 68114-4072

Mailing address

220 N 89TH St Ste 202
Omaha, NE 68114-4072
Phone (402) 502-5750

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1783900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1144149352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N 89TH ST STE 202",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144072",
            "telephone_number": "402-502-5750",
            "fax_number": "402-502-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N 89TH ST STE 202",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144072",
            "telephone_number": "402-502-5750",
            "fax_number": "402-502-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBALETI",
        "first_name": "DEDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-13",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NE",
            "license": "28753",
            "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 13, 2026; 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.