Individual provider Active NPI

Justin Shirk, DDS

  • Dentist
  • Lincoln, NE
National Provider Identifier
1144773698
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7309 Issued in NE
Practice address
4444 S 86TH St Ste 101
Lincoln, NE 68526-9253
Phone
(402) 483-7502
NPI assigned
Aug 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61816 KS
Dentist 122300000X 7309 NE Primary

Addresses

Primary practice location

4444 S 86TH St Ste 101
Lincoln, NE 68526-9253

Mailing address

4444 S 86TH St Ste 101
Lincoln, NE 68526-9253

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

State licenses

LicenseStateTypeSpecialty
61816KSMDDentist
7309NEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Justin Shirk DDS LLC CurrentSince Mar 11, 2025 Accepting new patients
Pioneer Greens Dentistry PastSince Mar 11, 2025 Accepting new patients

Locations

4444 S 86th St
Ste 101
Lincoln, NE 68526
Phone (402) 483-7502

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1144773698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 S 86TH ST STE 101",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 S 86TH ST STE 101",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685269253",
            "telephone_number": "402-483-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRK",
        "first_name": "JUSTIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-02",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "61816",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 24, 2025; 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.