Individual provider Active NPI

Dianne E Luebke, DDS

  • Dentist
  • Omaha, NE
National Provider Identifier
1164820783
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5979 Issued in NE
Practice address
2016 S 138TH Avenue Cir
Omaha, NE 68144-2148
Phone
(805) 215-8368
NPI assigned
Dec 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50709 CA
Dentist 122300000X 5979 NE Primary

Addresses

Primary practice location

2016 S 138TH Avenue Cir
Omaha, NE 68144-2148

Mailing address

2016 S 138TH Avenue Cir
Omaha, NE 68144-2148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240603000181 NE Order and Referring Only - DentistPractitioner - Dentist 5193267417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5979NEMDMental Health Counselor
50709CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1418428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1164820783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 S 138TH AVENUE CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S 138TH AVENUE CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442148",
            "telephone_number": "805-215-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEBKE",
        "first_name": "DIANNE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-13",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50709",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "5979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.