Active NPI
Scott R. O'Neil, D.D.S.
- General Practice Dentistry
- Nebraska City, NE
National Provider Identifier
1184638801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5602
- Practice address
- 205 N 13TH St
Nebraska City, NE 68410-1940 - Phone
- (402) 873-5059
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5602 | NE | Primary |
Addresses
Primary practice location
205 N 13TH St
Nebraska City, NE 68410-1940
Mailing address
205 N 13TH St
Nebraska City, NE 68410-1940
Phone (402) 873-5059
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47-0722311-00 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 10, 2015 through May 10, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5602 | NE | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184638801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 N 13TH ST",
"city": "NEBRASKA CITY",
"state": "NE",
"postal_code": "684101940",
"telephone_number": "402-873-5059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N 13TH ST",
"city": "NEBRASKA CITY",
"state": "NE",
"postal_code": "684101940",
"telephone_number": "402-873-5059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEIL",
"first_name": "SCOTT",
"middle_name": "R.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "5602",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47-0722311-00",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nebraska City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.