Derek A Fender, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5847 Issued in NE

Practice address

100 Indian Hills Drive
PO Box 250
Macy, NE 68039-0250

Phone

(402) 837-5381

Fax

(402) 837-5271

NPI assigned

Aug 23, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1164539573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 INDIAN HILLS DRIVE",
            "address_2": "PO BOX 250",
            "city": "MACY",
            "state": "NE",
            "postal_code": "680390250",
            "telephone_number": "402-837-5381",
            "fax_number": "402-837-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 INDIAN HILLS DRIVE",
            "address_2": "PO BOX 250",
            "city": "MACY",
            "state": "NE",
            "postal_code": "680390250",
            "telephone_number": "402-837-5381",
            "fax_number": "402-837-5271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1209 Harney St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681021894",
            "country_code": "US",
            "telephone_number": "402-342-3901",
            "fax_number": "402-934-9307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENDER",
        "first_name": "DEREK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "5847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl T Curtis Health Education Center
• Kelly Olsson Cromer, PHARMD
• Audrey Kay Cross, OTR L
• Charles A Dearborn, LPN0
• Sarah Mari Farrens, RN
• Ronald James Freemont Jr., NREMT I
• Jeffrey Gildow, PHARM.D.
• Robin R Gordon, RN
• Donald F Grant, LADC
• Joyce Marie Grant

• General Practice Dentistry in Macy, NE
• Providers in Macy, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.