NPIMap

Organization Active NPI

Superior Family Dental 107TH

  • Dental Clinic/Center
  • Omaha, NE
National Provider Identifier
1174862684
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
4294 Issued in NE
Legal business name
SUPERIOR FAMILY DENTAL 107TH
Practice address
10730 Pacific St
Ste105
Omaha, NE 68114-4799
Phone
(402) 391-1047
Fax
(402) 391-0309
NPI assigned
Feb 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
Donald G Smith Jr., DDS
Title
Owner
Phone
(402) 391-1047

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 4294 NE Primary

Addresses

Primary practice location

10730 Pacific St
Ste105
Omaha, NE 68114-4799

Mailing address

10730 Pacific St
Ste105
Omaha, NE 68114-4799
Phone (402) 391-1047

Other names 1

  • Superior Family Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1174862684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10730 PACIFIC ST",
            "address_2": "STE105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144799",
            "telephone_number": "402-391-1047",
            "fax_number": "402-391-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10730 PACIFIC ST",
            "address_2": "STE105",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144799",
            "telephone_number": "402-391-1047",
            "fax_number": "402-391-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR FAMILY DENTAL 107TH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-391-1047",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NE",
            "license": "4294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 4, 2013; 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.