Individual provider Active NPI

Sean Michael Daly, DDS

  • General Practice Dentistry
  • Hastings, NE
National Provider Identifier
1154345734
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6400 Issued in NE
Practice address
2217 W 12TH St Ste 1
Hastings, NE 68901-3660
Phone
(402) 463-6664
Fax
(402) 463-6900
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6400 NE Primary

Addresses

Primary practice location

2217 W 12TH St Ste 1
Hastings, NE 68901-3660

Mailing address

2217 W 12TH St Ste 1
Hastings, NE 68901-3660
Phone (402) 463-6664

Other identifiers 2

IdentifierTypeStateIssuer
760734095OtherNETAX ID
10024972100MedicaidNE

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
6400NEMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sean M Daly DDS PC CurrentSince Jun 2, 2024 Accepting new patients

Locations

2217 W 12th St
Ste 1
Hastings, NE 68901
Phone (402) 463-6664

Organizations & group practices 1

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1154345734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 W 12TH ST STE 1",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689013660",
            "telephone_number": "402-463-6664",
            "fax_number": "402-463-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 W 12TH ST STE 1",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689013660",
            "telephone_number": "402-463-6664",
            "fax_number": "402-463-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "760734095",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10024972100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.