Individual provider Active NPI

David L Swanson, DDS

  • General Practice Dentistry
  • North Platte, NE
National Provider Identifier
1184742504
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6094 Issued in NE
Practice address
721 E B St
North Platte, NE 69101-4248
Phone
(308) 534-3314
Fax
(308) 534-3318
NPI assigned
Mar 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6094 NE Primary

Addresses

Primary practice location

721 E B St
North Platte, NE 69101-4248

Mailing address

721 E B St
North Platte, NE 69101-4248
Phone (308) 534-3314

Other identifiers 1

IdentifierTypeStateIssuer
84107469400MedicaidNE

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
6094NEMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184742504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 E B ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691014248",
            "telephone_number": "308-534-3314",
            "fax_number": "308-534-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 E B ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691014248",
            "telephone_number": "308-534-3314",
            "fax_number": "308-534-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84107469400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.